Provider Demographics
NPI:1932736600
Name:SHEGOS, LAUREN KAY (DO)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:KAY
Last Name:SHEGOS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 W SOUTH BOUNDARY ST BLDG 9A
Mailing Address - Street 2:
Mailing Address - City:PERRYSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43551-5245
Mailing Address - Country:US
Mailing Address - Phone:419-873-6963
Mailing Address - Fax:419-873-6964
Practice Address - Street 1:900 W SOUTH BOUNDARY ST BLDG 9A
Practice Address - Street 2:
Practice Address - City:PERRYSBURG
Practice Address - State:OH
Practice Address - Zip Code:43551-5245
Practice Address - Country:US
Practice Address - Phone:419-873-6963
Practice Address - Fax:419-873-6964
Is Sole Proprietor?:No
Enumeration Date:2020-03-24
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34.017195207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology