Provider Demographics
NPI:1578916516
Name:SHERIDAN, PHILIP HENRY (MD)
Entity Type:Individual
Prefix:
First Name:PHILIP
Middle Name:HENRY
Last Name:SHERIDAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:FDA BUILDING 22 RM 4372
Mailing Address - Street 2:10903 NEW HAMPSHIRE AVENUE
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20993-0002
Mailing Address - Country:US
Mailing Address - Phone:301-796-1145
Mailing Address - Fax:301-796-9842
Practice Address - Street 1:FDA BUILDING 22 RM 4372
Practice Address - Street 2:10903 NEW HAMPSHIRE AVENUE
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20993-0002
Practice Address - Country:US
Practice Address - Phone:301-796-1145
Practice Address - Fax:301-796-9842
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-14
Last Update Date:2016-07-14
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Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101034855208000000X, 2084N0402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics