Healthcare Provider Details

I. General information

NPI: 1265936777
Provider Name (Legal Business Name): CAMERON CHARLES SHEEHAN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2018
Last Update Date: 06/09/2023
Certification Date: 06/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2222 CHERRY ST STE M800
TOLEDO OH
43608-2676
US

IV. Provider business mailing address

700 CHILDRENS DR
COLUMBUS OH
43205-2664
US

V. Phone/Fax

Practice location:
  • Phone: 419-251-1020
  • Fax: 419-251-1021
Mailing address:
  • Phone: 614-722-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YP0228X
TaxonomyPediatric Otolaryngology Physician
License Number35.148604
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: