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General NPI Number Information
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NPI Number | 1013984525
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Entity Type | Individual
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Provider Name | MARK F SHERIDAN MD
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Gender | Male
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Dates
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Enumeration Date | 03/02/2006
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Last Update Date | 07/25/2016
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Provider Practice Location Address
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Address Line | #3 STONECREST DR
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City | HUNTINGTON
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State | WV
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Zip | 25701
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Country | US
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Telephone | 304-522-6388
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Fax | 304-522-8040
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Provider Business Mailing Address
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Address Line | 2585 3RD AVE
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City | HUNTINGTON
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State | WV
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Zip | 25703-1642
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Country | US
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Telephone | 304-697-1396
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Fax | 304-697-2086
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 19499
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License Number State | WV
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Taxonomy #2
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 350788785
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 37594
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License Number State | KY
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