Organization Name: | JEROME A SHERARD MD PC |
NPI Number: | 1962620302 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JEROME A SHERARD (SOLE PROPRIETOR) |
Mailing Address: | 340 N Holtzclaw Ave Chattanooga |
State: | TN US |
Postal Code: | 374042305 |
Phone Number: | 4236243555 |
Fax Number: | 4236247030 |
NPI Enumeration Date: | 04/23/2007 |
NPI Last Update Date: | 11/19/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |