Provider Demographics
NPI:1861446460
Name:SHEILS, PHILIP C (MD)
Entity Type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:C
Last Name:SHEILS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 HAGEN DR
Mailing Address - Street 2:SUITE 220
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14625-2660
Mailing Address - Country:US
Mailing Address - Phone:585-586-2020
Mailing Address - Fax:585-586-2099
Practice Address - Street 1:10 HAGEN DR
Practice Address - Street 2:SUITE 220
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14625-2660
Practice Address - Country:US
Practice Address - Phone:585-586-2020
Practice Address - Fax:585-586-2099
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY178159207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY102589CROtherPREFERRED CARE
NY0143OtherEXCELLUS
NY1781590OtherWORKERS COMPENSATION
NY01150210Medicaid
NY5322318OtherAETNA
NY14169CMedicare ID - Type Unspecified
NY01150210Medicaid