Individual
DR. KENNETH JAMES SHEA III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3540 17TH AVE S, SAINT CLOUD, MN 56301-9664
(320) 766-2680
Mailing address
3540 17TH AVE S, SAINT CLOUD, MN 56301-9664
(320) 766-2680
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
57322
MN
2084V0102X
Vascular Neurology Physician
57322
MN
Other
Enumeration date
06/19/2008
Last updated
03/14/2023
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