Provider Demographics
NPI:1801938220
Name:GERRY PINETTE, SHEILA MELANIE (DO)
Entity type:Individual
Prefix:
First Name:SHEILA
Middle Name:MELANIE
Last Name:GERRY PINETTE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:SHEILA
Other - Middle Name:MELANIE
Other - Last Name:GERRY PINETTE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:301C US ROUTE 1
Mailing Address - Street 2:
Mailing Address - City:SCARBOROUGH
Mailing Address - State:ME
Mailing Address - Zip Code:04074-9701
Mailing Address - Country:US
Mailing Address - Phone:207-396-8600
Mailing Address - Fax:207-396-8632
Practice Address - Street 1:887 CONGRESS ST
Practice Address - Street 2:SUITE 200
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04102-3100
Practice Address - Country:US
Practice Address - Phone:207-771-5549
Practice Address - Fax:207-771-7834
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2014-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME1785207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEP00990467Medicare PIN
MEME018001Medicare PIN
MEH95524Medicare UPIN
MEME018002Medicare PIN
MEME0179Medicare PIN
MEME0180Medicare PIN