MEDICARE: STEPHEN PAUL SHEERIN 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	207R00000X	Internal Medicine Physician	G28180	CA

General Provider Information

NPI Number	:	1265427207
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHEN PAUL SHEERIN M.D.

Provider Business Mailing Address
First Line	:	751 LOMBARDI COURT
Second Line	:
City	:	SANTA ROSA
State	:	CA
Zip	:	95407
Country	:	US
Telephone Number	:	707-547-2222
Fax Number	:	707-547-2229

Provider Business Practice Location Address
First Line	:	751 LOMBARDI COURT
Second Line	:
City	:	SANTA ROSA
State	:	CA
Zip	:	95407
Country	:	US
Telephone Number	:	707-547-2222
Fax Number	:	707-547-2229

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

Provider Enumeration Date	:	09/15/2005
Last Update Date	:	11/21/2011

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