Healthcare Provider Details

I. General information

NPI: 1164643359
Provider Name (Legal Business Name): MICHAEL PAUL SHERMAN M.D., PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2007
Last Update Date: 09/23/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 LENNON LN
WALNUT CREEK CA
94598-2415
US

IV. Provider business mailing address

500 LENNON LN
WALNUT CREEK CA
94598-2415
US

V. Phone/Fax

Practice location:
  • Phone: 925-939-9610
  • Fax:
Mailing address:
  • Phone: 925-939-9610
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberG83108
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: