MEDICARE: DANIEL J SHERWOOD MD

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
1	207Q00000X	Family Medicine Physician	E4946	AR
2	207Q00000X	Family Medicine Physician	57869	TN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	P00374552	OTHER	AR	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	5N726	OTHER	AR	AR BLUE SHIELD #
3	P00374551	OTHER	MO	RR MDCR #
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	5N726	OTHER	MO	AR BLUE SHIELD #

General Provider Information

NPI Number	:	1205827565
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIEL J SHERWOOD MD

Provider Business Mailing Address
First Line	:	127 CRESTVIEW PARK DR STE 209
Second Line	:
City	:	DICKSON
State	:	TN
Zip	:	37055-2856
Country	:	US
Telephone Number	:	615-446-5121
Fax Number	:	615-446-1357

Provider Business Practice Location Address
First Line	:	2340 FAIRVIEW BLVD STE 100
Second Line	:
City	:	FAIRVIEW
State	:	TN
Zip	:	37062-9458
Country	:	US
Telephone Number	:	629-205-3018
Fax Number	:	629-205-3020

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/03/2005
Last Update Date	:	04/10/2019

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Directions to “ DANIEL J SHERWOOD MD” Practice Location

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