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NPI Code Detail

MEDICARE: STANLEY ROBERT SHERMAN D.O.

MEDICARE: STANLEY ROBERT SHERMAN D.O.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208600000XSurgery Physician3491OK

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1104886514
Entity Type Code : Individual
Provider Name (Legal Business Name) : STANLEY ROBERT SHERMAN D.O.
Provider Business Mailing Address
First Line : 101 S PARK LN
Second Line :
City : ALTUS
State : OK
Zip : 73521-5731
Country : US
Telephone Number : 580-379-6180
Fax Number : 580-379-6189
Provider Business Practice Location Address
First Line : 101 S PARK LN
Second Line :
City : ALTUS
State : OK
Zip : 73521-5731
Country : US
Telephone Number : 580-379-6180
Fax Number : 580-379-6189
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/28/2006
Last Update Date : 09/14/2022

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