1851435135 NPI number — SHERYL NEW MSBS

Table of content: SHERYL NEW MSBS (NPI 1851435135)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1851435135 NPI number — SHERYL NEW MSBS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NEW
Provider First Name:
SHERYL
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MSBS
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1851435135
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
11455 N MERIDIAN ST
Provider Second Line Business Mailing Address:
SUITE 150
Provider Business Mailing Address City Name:
CARMEL
Provider Business Mailing Address State Name:
IN
Provider Business Mailing Address Postal Code:
46032-1624
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
317-848-0001
Provider Business Mailing Address Fax Number:
317-848-0002

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
11455 N MERIDIAN ST
Provider Second Line Business Practice Location Address:
SUITE 150
Provider Business Practice Location Address City Name:
CARMEL
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
46032-1624
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
317-848-0001
Provider Business Practice Location Address Fax Number:
317-848-0002
Provider Enumeration Date:
02/19/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363AM0700X , with the licence number:  10000566A , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 000000489642 . This is a "ANTHEM BCBS" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com