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NPI Code Detail

MEDICARE: SHERIDAN CHILDREN HEALTHCARE SERVICES OF NEW MEXICO INC

MEDICARE: SHERIDAN CHILDREN HEALTHCARE SERVICES OF NEW MEXICO INC
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
1208000000XPediatrics Physician
22080N0001XNeonatal-Perinatal Medicine Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1NM007D87OTHERNMBC/BS
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1245213750
Entity Type Code : Organization
Provider Name (Legal Business Name) : SHERIDAN CHILDREN HEALTHCARE SERVICES OF NEW MEXICO INC
Provider Business Mailing Address
First Line : PO BOX 452036
Second Line :
City : SUNRISE
State : FL
Zip : 33345-2036
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4701 MONTGOMERY BLVD NE
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87109-1219
Country : US
Telephone Number : 954-838-2371
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : MR. ROBERT COWARD
Credential :
Telephone Number : 954-838-2371
Provider Enumeration Date : 11/29/2005
Last Update Date : 04/01/2011

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Directions to “SHERIDAN CHILDREN HEALTHCARE SERVICES OF NEW MEXICO INC ” Practice Location

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