Individual
THOMAS MICHAEL O SHEA JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-2255
Mailing address
PO BOX 344, WINSTON SALEM, NC 27102-0344
(336) 716-2255
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
25821
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2001750000
—
WV
01
—
28822
MEDCOST
NC
01
—
3633
PARTNERS
NC
01
—
5982104
AETNA
—
01
—
64258
BCBS
NC
05
—
6713297
—
VA
05
—
7964258
—
NC
05
—
Q25821
—
SC
Enumeration date
12/02/2005
Last updated
05/15/2008
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