Healthcare Provider Details

I. General information

NPI: 1689661498
Provider Name (Legal Business Name): JOHN M SHEARMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/06/2005
Last Update Date: 08/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

278 LAFAYETTE RD
PORTSMOUTH NH
03801-5455
US

IV. Provider business mailing address

278 LAFAYETTE RD
PORTSMOUTH NH
03801-5455
US

V. Phone/Fax

Practice location:
  • Phone: 603-431-0835
  • Fax: 603-431-1346
Mailing address:
  • Phone: 603-431-0835
  • Fax: 603-431-1346

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number5354
License Number StateNH
# 2
Primary TaxonomyN
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number011696
License Number StateME
# 3
Primary TaxonomyN
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number60527
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: