Healthcare Provider Details

I. General information

NPI: 1629657887
Provider Name (Legal Business Name): MONICA SHERIDAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2021
Last Update Date: 08/01/2026
Certification Date: 08/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1316 E 7TH ST
AUBURN IN
46706-2538
US

IV. Provider business mailing address

555 N MAIN ST # 1233
PROVIDENCE RI
02904-5722
US

V. Phone/Fax

Practice location:
  • Phone: 260-925-4600
  • Fax:
Mailing address:
  • Phone: 888-305-6286
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number01096539A
License Number StateIN
# 3
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number183323
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: