MEDICARE: SHELLEY RENEE DIGGINS O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	OEG000993	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1043422470
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHELLEY RENEE DIGGINS O.D.

Provider Business Mailing Address
First Line	:	954 PAMELA DR
Second Line	:
City	:	LOWER BURRELL
State	:	PA
Zip	:	15068-2711
Country	:	US
Telephone Number	:	724-335-0640
Fax Number	:

Provider Business Practice Location Address
First Line	:	1101 FREEPORT RD
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15238-3103
Country	:	US
Telephone Number	:	412-782-0400
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/06/2007
Last Update Date	:	03/17/2018

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