MEDICARE: DR. SUZANNE JOSEPHINE SHERMAN 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	207R00000X	Internal Medicine Physician	25MA04536800	NJ
2	2083P0500X	Preventive Medicine/Occupational Environmental Medicine Physician	25MA04536800	NJ
3	2083X0100X	Occupational Medicine Physician	G199575	CA

General Provider Information

NPI Number	:	1417103359
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SUZANNE JOSEPHINE SHERMAN MD

Provider Business Mailing Address
First Line	:	3912 FOREST HEIGHTS DR
Second Line	:
City	:	EAU CLAIRE
State	:	WI
Zip	:	54701-3105
Country	:	US
Telephone Number	:	701-403-4234
Fax Number	:

Provider Business Practice Location Address
First Line	:	3912 FOREST HEIGHTS DR
Second Line	:
City	:	EAU CLAIRE
State	:	WI
Zip	:	54701-3105
Country	:	US
Telephone Number	:	701-403-4234
Fax Number	:

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

Provider Enumeration Date	:	08/12/2008
Last Update Date	:	01/13/2025

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