Provider Demographics
NPI:1962564153
Name:O'SHEA, JAMES DENNIS (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:DENNIS
Last Name:O'SHEA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 EATON PL
Mailing Address - Street 2:STE 23
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01608-1232
Mailing Address - Country:US
Mailing Address - Phone:508-363-6515
Mailing Address - Fax:
Practice Address - Street 1:1 EATON PL
Practice Address - Street 2:STE 23
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01608-1232
Practice Address - Country:US
Practice Address - Phone:508-363-6515
Practice Address - Fax:508-363-7515
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2017-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH9685207RX0202X
MA238109207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAM20928OtherMEDICARE GROUP
MAM21583OtherMEDICARE GROUP SVPS
NH30009405Medicaid
MA110080674AMedicaid
NH30009405Medicaid