1023110269 NPI number — DR. F. SCOTT SHERMAN MD

Table of content: DR. F. SCOTT SHERMAN MD (NPI 1023110269)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1023110269 NPI number — DR. F. SCOTT SHERMAN MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SHERMAN
Provider First Name:
F. SCOTT
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SHERMAN
Provider Other First Name:
FRANK
Provider Other Middle Name:
SCOTT
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1023110269
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
411 SPRINGDALE RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EIGHTY FOUR
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15330-2649
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
315-706-1121
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
419 GEORGIAN PL
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SOMERSET
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15501-1612
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-377-1152
Provider Business Practice Location Address Fax Number:
410-221-1343
Provider Enumeration Date:
09/01/2006

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: 207L00000X , with the licence number:  1647341 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207L00000X , with the licence number: 002221 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207L00000X , with the licence number: ME110785 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 002221 . This is a "MD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: MD05886L . This is a "LICENSURE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 115306100 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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