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General NPI Number Information
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NPI Number | 1700315512
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Entity Type | Individual
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Provider Name | KERRY MARIE SHEAHAN DO
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Gender | Female
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Dates
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Enumeration Date | 06/06/2017
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Last Update Date | 07/06/2023
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Provider Practice Location Address
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Address Line | 550 PHARR RD NE STE 605
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City | ATLANTA
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State | GA
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Zip | 30305-3469
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Country | US
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Telephone | 404-235-5982
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Fax |
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Provider Business Mailing Address
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Address Line | 550 PHARR RD NE STE 605
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City | ATLANTA
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State | GA
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Zip | 30305-3469
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Country | US
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Telephone | 404-919-9867
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | 272274
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | 91410
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License Number State | GA
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