Provider Demographics
NPI:1932380664
Name:SHEAHAN, PATRICK O'BRIEN (MB MD FRCSI-ORL)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:O'BRIEN
Last Name:SHEAHAN
Suffix:
Gender:M
Credentials:MB MD FRCSI-ORL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 RUTLEDGE ST
Mailing Address - Street 2:SUITE 1130
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29425-8903
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:135 RUTLEDGE ST
Practice Address - Street 2:SUITE 1130
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29425-8903
Practice Address - Country:US
Practice Address - Phone:843-792-2300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-22
Last Update Date:2007-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCLL30305207Y00000X
NYP54781208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
No208600000XAllopathic & Osteopathic PhysiciansSurgery