Provider Demographics
NPI:1275917858
Name:SHIRLEY, MEGHAN (OD)
Entity Type:Individual
Prefix:DR
First Name:MEGHAN
Middle Name:
Last Name:SHIRLEY
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4203 MURRAY AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15217-2975
Mailing Address - Country:US
Mailing Address - Phone:412-421-2020
Mailing Address - Fax:412-421-2020
Practice Address - Street 1:4203 MURRAY AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15217-2975
Practice Address - Country:US
Practice Address - Phone:412-421-2020
Practice Address - Fax:412-422-2020
Is Sole Proprietor?:No
Enumeration Date:2015-07-14
Last Update Date:2020-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG003029152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist