Individual
MICHAEL P SHAUGHNESSY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
29001 CEDAR RD STE 110, LYNDHURST, OH 44124-4041
(216) 382-8022
(216) 382-7667
Mailing address
PO BOX 378, SANDUSKY, OH 44871-0378
(419) 626-6161
(419) 502-3511
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
35079538
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2305204
—
OH
01
—
H600381
MEDICARE
OH
Enumeration date
05/19/2006
Last updated
06/22/2020
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