Healthcare Provider Details

I. General information

NPI: 1649433384
Provider Name (Legal Business Name): SHERRY SEDBERRY ROSS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/02/2008
Last Update Date: 08/10/2021
Certification Date: 08/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 CENTRAL DR
SANFORD NC
27330-4159
US

IV. Provider business mailing address

UNIVERSITY OF NORTH CAROLINA AT CHAPEL HL 170 MANNING DRIVE, CB 7235
CHAPEL HILL NC
27599-7235
US

V. Phone/Fax

Practice location:
  • Phone: 919-718-9512
  • Fax: 919-718-9516
Mailing address:
  • Phone: 919-962-7876
  • Fax: 919-843-5956

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2088P0231X
TaxonomyPediatric Urology Physician
License NumberMD035527
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code2088P0231X
TaxonomyPediatric Urology Physician
License Number2008-01882
License Number StateNC
# 3
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number200801882
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: