Provider Demographics
NPI:1326592635
Name:GEOGHEGAN, SHEENA ELIZABETH (MD)
Entity Type:Individual
Prefix:MS
First Name:SHEENA
Middle Name:ELIZABETH
Last Name:GEOGHEGAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:128 E, APPLE ST. SUITE 1820
Mailing Address - Street 2:WSU DEPT. OF GERIATRICS
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45409
Mailing Address - Country:US
Mailing Address - Phone:937-208-6359
Mailing Address - Fax:937-208-3096
Practice Address - Street 1:725 UNIVERISITY BLVD.
Practice Address - Street 2:WRIGHT STATE PHYSICIANS
Practice Address - City:FAIRBORN
Practice Address - State:OH
Practice Address - Zip Code:45324
Practice Address - Country:US
Practice Address - Phone:937-245-7200
Practice Address - Fax:937-245-7937
Is Sole Proprietor?:No
Enumeration Date:2016-08-04
Last Update Date:2016-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program