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General NPI Number Information
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NPI Number | 1023352424
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Entity Type | Organization
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Legal Business Name | DAVE SHERWOOD FAMILY MEDICINE PLLC
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Dates
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Enumeration Date | 11/26/2012
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Last Update Date | 11/26/2012
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Provider Practice Location Address
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Address Line | 570 PALOMINO TRL
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City | RIDGWAY
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State | CO
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Zip | 81432-9215
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Country | US
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Telephone | 970-626-4370
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Fax | 970-626-3442
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Provider Business Mailing Address
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Address Line | 570 PALOMINO TRL
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City | RIDGWAY
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State | CO
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Zip | 81432-9215
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Country | US
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Telephone | 970-626-4370
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Fax | 970-626-3442
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Authorized Official
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Title or Position | PHYICIAN
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Name | DR. LORAN D SHERWOOD
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Credential | MD
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Telephone | 970-262-4370
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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