Provider Demographics
NPI:1295734192
Name:SHEEHAN, JAMES W (DC)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:W
Last Name:SHEEHAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2207 CONCORD PIKE # 397
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19803-2908
Mailing Address - Country:US
Mailing Address - Phone:302-545-7441
Mailing Address - Fax:800-948-6089
Practice Address - Street 1:2101 FOULK RD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19810-4710
Practice Address - Country:US
Practice Address - Phone:302-332-4525
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-21
Last Update Date:2014-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEFI-0000516111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT3721706OtherAETNA
DE51-0256713OtherBLUE CROSS
V04052Medicare UPIN
DEG01891U04Medicare ID - Type UnspecifiedMEDICARE
DEV04052Medicare UPIN