Provider Demographics
NPI:1356328801
Name:SHEA, DONALD B (MD)
Entity type:Individual
Prefix:DR
First Name:DONALD
Middle Name:B
Last Name:SHEA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 468
Mailing Address - Street 2:
Mailing Address - City:SKOWHEGAN
Mailing Address - State:ME
Mailing Address - Zip Code:04976-0468
Mailing Address - Country:US
Mailing Address - Phone:207-858-8367
Mailing Address - Fax:207-474-9261
Practice Address - Street 1:61 FAIRVIEW AVE
Practice Address - Street 2:
Practice Address - City:SKOWHEGAN
Practice Address - State:ME
Practice Address - Zip Code:04976-1403
Practice Address - Country:US
Practice Address - Phone:207-858-8121
Practice Address - Fax:207-474-3648
Is Sole Proprietor?:No
Enumeration Date:2005-12-27
Last Update Date:2025-07-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NH9714207RC0000X
MEMD18015207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME1356328801Medicaid
NH30009637Medicaid
MEP01025980Medicare PIN
NH30009637Medicaid