Provider Demographics
NPI:1528260866
Name:SHERICK, STEPHEN VINCENT (MD)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:VINCENT
Last Name:SHERICK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 S BELLAIRE ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80246-1010
Mailing Address - Country:US
Mailing Address - Phone:303-718-9179
Mailing Address - Fax:
Practice Address - Street 1:35 S BELLAIRE ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80246
Practice Address - Country:US
Practice Address - Phone:303-718-9179
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-31
Last Update Date:2021-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORLL16336207P00000X
CO0047548207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN300015624Medicaid
P00793514OtherMEDICARE RR
CO11953063Medicaid
COC304701Medicare PIN