Healthcare Provider Details

I. General information

NPI: 1780773226
Provider Name (Legal Business Name): RONALD L. SHERMAN DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: RONALD L. SHERMAN DPM

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 N. WOLFE STREET HALSTED 668
BALTIMORE MD
21287
US

IV. Provider business mailing address

600 N.WOLFE STREET HALSTED 668
BALTIMORE MD
21287
US

V. Phone/Fax

Practice location:
  • Phone: 410-955-5165
  • Fax: 410-614-2079
Mailing address:
  • Phone: 410-955-5165
  • Fax: 410-614-2079

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License Number00672
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: