Individual
DR. DIANE MARIE SHERIDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1624 10TH ST, SUITE 1, MINDEN, NV 89423-4413
(775) 782-0700
(775) 782-0500
Mailing address
1624 10TH ST, SUITE 1, MINDEN, NV 89423-4413
(775) 782-0700
(775) 782-0500
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
7773
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1841429263
GROUP NPI
—
05
—
2003010
—
NV
01
—
41490
BCBS NUMBER
NV
01
—
BX462A
MEDICARE PTAN
—
Enumeration date
05/24/2006
Last updated
01/19/2011
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