Provider Demographics
NPI:1730784455
Name:MARQUIS, SHEILA WENDY
Entity type:Individual
Prefix:
First Name:SHEILA
Middle Name:WENDY
Last Name:MARQUIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:68 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01810-3846
Mailing Address - Country:US
Mailing Address - Phone:978-470-0542
Mailing Address - Fax:978-475-8054
Practice Address - Street 1:68 MAIN ST
Practice Address - Street 2:
Practice Address - City:ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01810-3846
Practice Address - Country:US
Practice Address - Phone:978-470-0542
Practice Address - Fax:978-475-8054
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-01
Last Update Date:2020-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH22913183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist