MEDICARE: JOHN C. SHEHAN M.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	207RP1001X	Pulmonary Disease Physician	19020	NE

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1902800287
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN C. SHEHAN M.D.

Provider Business Mailing Address
First Line	:	PO BOX 3755
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68103-0755
Country	:	US
Telephone Number	:	402-354-2100
Fax Number	:	402-354-4230

Provider Business Practice Location Address
First Line	:	1120 N 103RD PLZ STE 102
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68114-1119
Country	:	US
Telephone Number	:	402-354-0220
Fax Number	:	402-354-0225

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

Provider Enumeration Date	:	06/02/2005
Last Update Date	:	02/01/2018

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Directions to “ JOHN C. SHEHAN M.D.” Practice Location

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