Provider Demographics
NPI:1205579083
Name:O'SHEA, JOHN MICHAEL (PHD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:MICHAEL
Last Name:O'SHEA
Suffix:
Gender:M
Credentials:PHD
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Mailing Address - Street 1:515 E 100 S STE 200
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84102-2095
Mailing Address - Country:US
Mailing Address - Phone:801-581-2401
Mailing Address - Fax:801-585-2507
Practice Address - Street 1:515 E 100 S STE 200
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84102-2095
Practice Address - Country:US
Practice Address - Phone:801-581-2401
Practice Address - Fax:801-585-2507
Is Sole Proprietor?:No
Enumeration Date:2022-04-19
Last Update Date:2022-04-19
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170100000XOther Service ProvidersMedical Genetics, Ph.D. Medical Genetics