Healthcare Provider Details

I. General information

NPI: 1013917004
Provider Name (Legal Business Name): ROBERT E. SHERMAN D.P.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 07/31/2005
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3446 MAIN ST
STRATFORD CT
06614-4118
US

IV. Provider business mailing address

3446 MAIN ST
STRATFORD CT
06614-4118
US

V. Phone/Fax

Practice location:
  • Phone: 203-375-1370
  • Fax: 203-377-2410
Mailing address:
  • Phone: 203-375-1370
  • Fax: 203-377-2410

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number000188
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: