Healthcare Provider Details

I. General information

NPI: 1447245329
Provider Name (Legal Business Name): IRVING GARY SHERMAN DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/15/2005
Last Update Date: 11/19/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8302 HOPE POINT CT
MILLERSVILLE MD
21108-1401
US

IV. Provider business mailing address

8302 HOPE POINT CT
MILLERSVILLE MD
21108-1401
US

V. Phone/Fax

Practice location:
  • Phone: 410-987-3800
  • Fax: 410-987-3887
Mailing address:
  • Phone: 410-987-3800
  • Fax: 410-987-3887

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number01396
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: