Provider Demographics
NPI:1710444872
Name:SHERIDAN, ANDREW (CSFA)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:
Last Name:SHERIDAN
Suffix:
Gender:M
Credentials:CSFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15524 GOLDEN RIDGE CT
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-5124
Mailing Address - Country:US
Mailing Address - Phone:636-346-8182
Mailing Address - Fax:
Practice Address - Street 1:15524 GOLDEN RIDGE CT
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-5124
Practice Address - Country:US
Practice Address - Phone:636-346-8182
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-25
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Multi-Specialty