Healthcare Provider Details

I. General information

NPI: 1932215704
Provider Name (Legal Business Name): SHERIDAN CHILDRENS HEALTHCARE SERVICES OF VIRGINIA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2006
Last Update Date: 02/08/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1602 SKIPWITH RD
RICHMOND VA
23229-5205
US

IV. Provider business mailing address

PO BOX 452409
SUNRISE FL
33345-2409
US

V. Phone/Fax

Practice location:
  • Phone: 804-289-4500
  • Fax:
Mailing address:
  • Phone: 954-838-2371
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code2080P0203X
TaxonomyPediatric Critical Care Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: ROBERT COWARD
Title or Position: PRESIDENT
Credential:
Phone: 954-838-2371