Healthcare Provider Details

I. General information

NPI: 1841510864
Provider Name (Legal Business Name): SHEILA KARINA VELASCO PASCUAL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2010
Last Update Date: 10/31/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33 WHITING HILL RD
BREWER ME
04412-1004
US

IV. Provider business mailing address

43 WHITING HILL RD STE 300
BREWER ME
04412-1006
US

V. Phone/Fax

Practice location:
  • Phone: 207-973-7478
  • Fax: 207-973-9807
Mailing address:
  • Phone: 207-973-3500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number018465
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: