Provider Demographics
NPI:1124832092
Name:SHEGON, MARY STEWART
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:STEWART
Last Name:SHEGON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1240 WALES AVE
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35213-1414
Mailing Address - Country:US
Mailing Address - Phone:334-312-0571
Mailing Address - Fax:
Practice Address - Street 1:3140 CAHABA HEIGHTS RD STE 102
Practice Address - Street 2:
Practice Address - City:VESTAVIA
Practice Address - State:AL
Practice Address - Zip Code:35243-5243
Practice Address - Country:US
Practice Address - Phone:205-969-8080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-03
Last Update Date:2025-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL6603225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist