Provider Demographics
NPI:1023212602
Name:O'SHEA, CATHERINE NOELLE (DO)
Entity Type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:NOELLE
Last Name:O'SHEA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8501 JACKS FORK DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80924-8117
Mailing Address - Country:US
Mailing Address - Phone:850-543-6496
Mailing Address - Fax:
Practice Address - Street 1:8501 JACKS FORK DR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80924-8117
Practice Address - Country:US
Practice Address - Phone:850-543-6496
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-14
Last Update Date:2013-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP1-0026274207R00000X
CODR.0053021207RG0100X
ALDO1252207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
3858306751OtherMYUTMB 3858306751-COMMERCIAL NUMBER