Healthcare Provider Details

I. General information

NPI: 1427457225
Provider Name (Legal Business Name): DONALD C SHERIDAN MD, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2014
Last Update Date: 11/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10213 N 92ND ST 101
SCOTTSDALE AZ
85258-4561
US

IV. Provider business mailing address

10213 N 92ND STREET 101
SCOTTSDALE AZ
85258
US

V. Phone/Fax

Practice location:
  • Phone: 480-860-6005
  • Fax: 480-860-1882
Mailing address:
  • Phone: 480-860-6005
  • Fax: 480-860-1882

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number24106
License Number StateAZ

VIII. Authorized Official

Name: DONALD C SHERIDAN
Title or Position: PRESIDENT
Credential: MD
Phone: 480-860-6005