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General NPI Number Information
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NPI Number | 1285588442
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Entity Type | Organization
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Legal Business Name | SHERIDAN COMMUNITY HOSPITAL
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Dates
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Enumeration Date | 02/24/2026
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Last Update Date | 02/24/2026
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Provider Practice Location Address
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Address Line | 1525 E BELTLINE AVE NE
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City | GRAND RAPIDS
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State | MI
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Zip | 49525-4598
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Country | US
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Telephone | 989-291-6304
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Fax |
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Provider Business Mailing Address
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Address Line | 301 N MAIN ST
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City | SHERIDAN
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State | MI
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Zip | 48884-9235
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Country | US
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Telephone | 989-291-6304
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Fax | 989-291-6304
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Authorized Official
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Title or Position | COMPLIANCE OFFICER
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Name | JAMES DIMITRIOU
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Credential |
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Telephone | 989-291-6304
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207XX0004X
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Taxonomy Name | Orthopaedic Foot and Ankle Surgery Physician
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License Number |
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License Number State |
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