Healthcare Provider Details

I. General information

NPI: 1417632993
Provider Name (Legal Business Name): GEORGE A SHERMAN DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/21/2023
Last Update Date: 06/21/2023
Certification Date: 06/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2323 MEMORIAL AVE STE 10
LYNCHBURG VA
24501-2652
US

IV. Provider business mailing address

2323 MEMORIAL AVE STE 10
LYNCHBURG VA
24501-2652
US

V. Phone/Fax

Practice location:
  • Phone: 434-200-5200
  • Fax:
Mailing address:
  • Phone: 434-200-5200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number0116038440
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: