Provider Demographics
NPI:1326108713
Name:BAUGHMAN, SHERILYN (MD)
Entity Type:Individual
Prefix:DR
First Name:SHERILYN
Middle Name:
Last Name:BAUGHMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3189 DANVILLE BLVD STE 130
Mailing Address - Street 2:
Mailing Address - City:ALAMO
Mailing Address - State:CA
Mailing Address - Zip Code:94507-1955
Mailing Address - Country:US
Mailing Address - Phone:925-362-0992
Mailing Address - Fax:925-362-0979
Practice Address - Street 1:3189 DANVILLE BLVD STE 130
Practice Address - Street 2:
Practice Address - City:ALAMO
Practice Address - State:CA
Practice Address - Zip Code:94507-1955
Practice Address - Country:US
Practice Address - Phone:925-362-0992
Practice Address - Fax:925-362-0979
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-08
Last Update Date:2012-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG48323207ND0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA51009Medicare UPIN