Individual
DR. ROBERT LEO SHERIDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
51 BLOSSOM STREET, SBI SHRINERS BURN INSTITUTE, BOSTON, MA 02114
(617) 726-5633
(617) 367-8936
Mailing address
PO BOX 9142, MASS GENERAL PHYSICIAN ORGANIZATION, CHARLESTOWN, MA 02129-9142
(617) 726-5633
(617) 371-4740
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
74746
MA
2086S0102X
Surgical Critical Care Physician
74746
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
074746
TUFTS HEALTH PLAN
MA
05
—
3081389
—
MA
01
—
J11455
BCBS MA
MA
Enumeration date
11/18/2005
Last updated
11/14/2012
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