Provider Demographics
NPI:1063733236
Name:SHEA, MEGHAN E (MD)
Entity type:Individual
Prefix:
First Name:MEGHAN
Middle Name:E
Last Name:SHEA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 BROOKLINE AVE.
Mailing Address - Street 2:SHAPIRO 9
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215
Mailing Address - Country:US
Mailing Address - Phone:617-667-2100
Mailing Address - Fax:617-975-5665
Practice Address - Street 1:330 BROOKLINE AVE
Practice Address - Street 2:SHAPIRO 9
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215-5400
Practice Address - Country:US
Practice Address - Phone:617-667-2100
Practice Address - Fax:617-975-5665
Is Sole Proprietor?:No
Enumeration Date:2010-06-22
Last Update Date:2019-01-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MAL-244125207R00000X
MA251127207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine