Basic Information
| Provider Information | |||||||||
| NPI: | 1497118731 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SHEA | ||||||||
| FirstName: | MEGAN | ||||||||
| MiddleName: | L. | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3938 SILSBY RD | ||||||||
| Address2: | |||||||||
| City: | UNIVERSITY HEIGHTS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441183104 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8045437485 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 9500 EUCLID AVE # S1-20 | ||||||||
| Address2: | |||||||||
| City: | CLEVELAND | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441954870 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2164444998 | ||||||||
| FaxNumber: | 2166363363 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/04/2016 | ||||||||
| LastUpdateDate: | 07/08/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 34.013999 | OH | Y | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.