Healthcare Provider Details

I. General information

NPI: 1710144670
Provider Name (Legal Business Name): MICHAEL JAREED SHERMAN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2008
Last Update Date: 10/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 IRVING ST NW
WASHINGTON DC
20010-3017
US

IV. Provider business mailing address

110 IRVING ST NW SUITE 2A70
WASHINGTON DC
20010-3017
US

V. Phone/Fax

Practice location:
  • Phone: 202-877-6034
  • Fax: 202-877-8329
Mailing address:
  • Phone: 202-877-6034
  • Fax: 202-877-8329

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License NumberDO034202
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: