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General NPI Number Information
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NPI Number | 1013975796
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Entity Type | Individual
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Provider Name | SHERRY HIGGINBOTHAM O.D.
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Gender | Female
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Dates
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Enumeration Date | 05/03/2006
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Last Update Date | 11/30/2020
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Provider Practice Location Address
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Address Line | 750 MAIN ST STE 301A
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City | REISTERSTOWN
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State | MD
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Zip | 21136-2517
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Country | US
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Telephone | 410-526-3060
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Fax | 410-584-2243
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Provider Business Mailing Address
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Address Line | 515 FAIRMOUNT AVE STE 400
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City | TOWSON
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State | MD
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Zip | 21286-8518
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Country | US
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Telephone | 410-526-3060
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Fax | 410-584-2243
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | TA1490
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License Number State | MD
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