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General NPI Number Information
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NPI Number | 1003869413
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Entity Type | Individual
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Provider Name | GARY BRADLEY SHERRILL M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/18/2006
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Last Update Date | 09/20/2021
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Provider Practice Location Address
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Address Line | 501 N ELAM AVE
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City | GREENSBORO
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State | NC
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Zip | 27403-1118
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Country | US
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Telephone | 336-832-1100
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 14878
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City | GREENSBORO
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State | NC
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Zip | 27415-4878
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Country | US
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Telephone | 336-547-1877
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 36633
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | 36633
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License Number State | NC
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