Provider Demographics
NPI:1477002384
Name:SHERIDAN, MOLLY BARBARA (PHD)
Entity type:Individual
Prefix:
First Name:MOLLY
Middle Name:BARBARA
Last Name:SHERIDAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1812 ASHLAND AVE
Mailing Address - Street 2:ROOM 236
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21205-1506
Mailing Address - Country:US
Mailing Address - Phone:443-287-5485
Mailing Address - Fax:410-955-0484
Practice Address - Street 1:1812 ASHLAND AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21205-1506
Practice Address - Country:US
Practice Address - Phone:443-287-5485
Practice Address - Fax:410-955-0484
Is Sole Proprietor?:No
Enumeration Date:2016-10-04
Last Update Date:2016-10-04
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170100000XOther Service ProvidersMedical Genetics, Ph.D. Medical Genetics