Healthcare Provider Details

I. General information

NPI: 1295185718
Provider Name (Legal Business Name): FORREST SHERMAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2016
Last Update Date: 08/08/2022
Certification Date: 08/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 OGLETHORPE AVE STE 600EF
ATHENS GA
30606-2179
US

IV. Provider business mailing address

1500 E. MEDICAL CENTER DRIVE D3230 MPB, SPC 5718
ANN ARBOR MI
48109-5718
US

V. Phone/Fax

Practice location:
  • Phone: 706-613-5980
  • Fax:
Mailing address:
  • Phone: 734-763-9251
  • Fax: 734-763-4208

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number4301109798
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number91924
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: