Provider Demographics
NPI:1598722035
Name:KENDRICK, SHEILA J (MD)
Entity Type:Individual
Prefix:DR
First Name:SHEILA
Middle Name:J
Last Name:KENDRICK
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:PO BOX 416
Mailing Address - Street 2:
Mailing Address - City:ASCUTNEY
Mailing Address - State:VT
Mailing Address - Zip Code:05030
Mailing Address - Country:US
Mailing Address - Phone:802-674-6744
Mailing Address - Fax:802-674-6772
Practice Address - Street 1:14 ASCUTNEY PLACE
Practice Address - Street 2:UNIT B2
Practice Address - City:ASCUTNEY
Practice Address - State:VT
Practice Address - Zip Code:05030
Practice Address - Country:US
Practice Address - Phone:802-674-6744
Practice Address - Fax:802-674-6772
Is Sole Proprietor?:No
Enumeration Date:2006-04-27
Last Update Date:2013-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0420009084207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT0VN1150Medicaid
VT0VN1150Medicaid
VTVN1150Medicare PIN