Provider Demographics
NPI:1659540698
Name:SHERIDAN, KATHLEEN (DO)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:
Last Name:SHERIDAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3601 5TH AVE STE 700
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213-3403
Mailing Address - Country:US
Mailing Address - Phone:412-648-6801
Mailing Address - Fax:
Practice Address - Street 1:9104 BABCOCK BLVD STE 2116
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15237-5818
Practice Address - Country:US
Practice Address - Phone:412-348-0330
Practice Address - Fax:412-348-0338
Is Sole Proprietor?:No
Enumeration Date:2008-02-25
Last Update Date:2024-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS013937207R00000X, 207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine