Provider Demographics
NPI:1982610929
Name:SHEERAN, PATRICK JOHN (DC)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:JOHN
Last Name:SHEERAN
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 1:36 44TH ST SW
Mailing Address - Street 2:
Mailing Address - City:GRANDVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:49418-2177
Mailing Address - Country:US
Mailing Address - Phone:616-457-5700
Mailing Address - Fax:616-457-5700
Practice Address - Street 1:36 44TH ST SW
Practice Address - Street 2:
Practice Address - City:GRANDVILLE
Practice Address - State:MI
Practice Address - Zip Code:49418-2177
Practice Address - Country:US
Practice Address - Phone:616-457-5700
Practice Address - Fax:616-457-5700
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2008-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301005261111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI950G011560OtherBCBS OF MICHIGAN
MIP00467155OtherRAILROAD MEDICARE
MIP11143913OtherMULTIPLAN
MIP90582OtherBCN OF MICHIGAN
MIU23860Medicare UPIN
MI950G011560OtherBCBS OF MICHIGAN