Provider Demographics
NPI:1497118731
Name:SHEA, MEGAN L (DO)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:L
Last Name: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 1:3938 SILSBY RD
Mailing Address - Street 2:
Mailing Address - City:UNIVERSITY HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44118-3104
Mailing Address - Country:US
Mailing Address - Phone:804-543-7485
Mailing Address - Fax:
Practice Address - Street 1:9500 EUCLID AVE # S1-20
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44195-4870
Practice Address - Country:US
Practice Address - Phone:216-444-4998
Practice Address - Fax:216-636-3363
Is Sole Proprietor?:No
Enumeration Date:2016-04-04
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34.013999208000000X
TXU43372080P0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0203XAllopathic & Osteopathic PhysiciansPediatricsPediatric Critical Care Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics