Healthcare Provider Details

I. General information

NPI: 1962421917
Provider Name (Legal Business Name): SHERMAN AUSTIN YEARGAN III M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2006
Last Update Date: 06/07/2023
Certification Date: 06/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5725 OLEANDER DR UNIT E, BLDG. 4
WILMINGTON NC
28403-4724
US

IV. Provider business mailing address

5725 OLEANDER DR UNIT E, BLDG. 4
WILMINGTON NC
28403-4724
US

V. Phone/Fax

Practice location:
  • Phone: 910-769-7878
  • Fax: 910-769-8967
Mailing address:
  • Phone: 910-769-7878
  • Fax: 910-769-8967

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number200601004
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: