Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 19499 | WV |
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 350788785 | OH |
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 37594 | KY |
NPI | 1013984525 |
---|---|
Provider Name | Mr. Mark F Sheridan |
First Address | Huntington, WV 25703-1642 |
Second Address | Huntington, WV 25701 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/03/2006 |
Last Update Date | 25/07/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0101257000 | (05) | WV |
2091909 | (05) | OH |
64942527 | (05) | KY |
G27977 | (02) |