Provider Demographics
NPI:1164049888
Name:SHEA, JAMES MICHAEL (DPM)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:MICHAEL
Last Name:SHEA
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3802 6TH AVE
Mailing Address - Street 2:
Mailing Address - City:KENOSHA
Mailing Address - State:WI
Mailing Address - Zip Code:53140-5519
Mailing Address - Country:US
Mailing Address - Phone:262-914-2800
Mailing Address - Fax:
Practice Address - Street 1:4800 FOURNACE PL
Practice Address - Street 2:
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-2324
Practice Address - Country:US
Practice Address - Phone:346-426-0432
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-29
Last Update Date:2025-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1349-25213E00000X
TX692219213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist