Provider Demographics
NPI:1043355993
Name:MICHAEL, DAWN O'SHEA (OD)
Entity Type:Individual
Prefix:DR
First Name:DAWN
Middle Name:O'SHEA
Last Name:MICHAEL
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:13 STONY LN
Mailing Address - Street 2:
Mailing Address - City:SMITHFIELD
Mailing Address - State:RI
Mailing Address - Zip Code:02917-2450
Mailing Address - Country:US
Mailing Address - Phone:401-232-5997
Mailing Address - Fax:401-874-7559
Practice Address - Street 1:50 LOWER COLLEGE ROAD
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:RI
Practice Address - Zip Code:02881-0820
Practice Address - Country:US
Practice Address - Phone:401-874-4063
Practice Address - Fax:401-874-7559
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIODT 453152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist