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General NPI Number Information
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NPI Number | 1205925344
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Entity Type | Individual
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Provider Name | LORAN DAVID SHERWOOD M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/12/2006
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Last Update Date | 11/15/2013
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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 | 81432-9246
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Country | US
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Telephone | 970-626-5123
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Fax | 970-626-9783
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Provider Business Mailing Address
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Address Line | PO BOX 270
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City | RIDGWAY
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State | CO
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Zip | 81432-0270
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Country | US
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Telephone | 970-626-5123
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Fax | 970-626-9783
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 35376
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License Number State | CO
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