Individual
ANTHONY THOMAS SHERIDAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
12124 W LAKESHORE DR, BRIMLEY, MI 49715-9319
(906) 248-5527
(906) 248-5765
Mailing address
12124 W LAKESHORE DR, BRIMLEY, MI 49715-9319
(906) 248-5527
(906) 248-5765
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301060379
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0807334182
BSFEP
MI
05
—
3065475
—
MI
01
—
4514150
A43
MI
Enumeration date
07/25/2006
Last updated
12/14/2007
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