Provider Demographics
NPI:1659530178
Name:SHEA, MICHAEL LEIGH (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:LEIGH
Last Name:SHEA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1113 S STATE ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19901-4112
Mailing Address - Country:US
Mailing Address - Phone:302-734-7676
Mailing Address - Fax:302-734-7615
Practice Address - Street 1:1113 S STATE ST
Practice Address - Street 2:SUITE 100
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19901-4112
Practice Address - Country:US
Practice Address - Phone:302-734-7676
Practice Address - Fax:302-734-7615
Is Sole Proprietor?:No
Enumeration Date:2008-06-09
Last Update Date:2015-04-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY244549207RC0000X
DEC1-0009461207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease