MEDICARE: DR. PATRICK JOHN SHEERAN D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	2301005261	MI

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00467155	OTHER	MI	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	950G011560	OTHER	MI	BCBS OF MICHIGAN
3	P11143913	OTHER	MI	MULTIPLAN
4	P90582	OTHER	MI	BCN OF MICHIGAN

General Provider Information

NPI Number	:	1982610929
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PATRICK JOHN SHEERAN D.C.

Provider Business Mailing Address
First Line	:	36 44TH ST SW
Second Line	:
City	:	GRANDVILLE
State	:	MI
Zip	:	49418-2177
Country	:	US
Telephone Number	:	616-457-5700
Fax Number	:	616-457-5700

Provider Business Practice Location Address
First Line	:	36 44TH ST SW
Second Line	:
City	:	GRANDVILLE
State	:	MI
Zip	:	49418-2177
Country	:	US
Telephone Number	:	616-457-5700
Fax Number	:	616-457-5700

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/31/2006
Last Update Date	:	05/15/2008

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