=====================================================
General NPI Number Information
=====================================================
NPI Number | 1437245016
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | JAMES C. SHERMAN MD PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/04/2006
-----------------------------------------------------
Last Update Date | 01/21/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 501 BLACKBURN DR
-----------------------------------------------------
City | MARTINEZ
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30907-8201
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 706-854-8340
-----------------------------------------------------
Fax | 706-724-9562
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1430 B HARPER STREET
-----------------------------------------------------
City | AUGUSTA
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30901
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 706-724-5451
-----------------------------------------------------
Fax | 706-724-9562
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PHYSICIAN
-----------------------------------------------------
Name | JAMES CARMICHAEL SHERMAN
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 706-724-5451
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208600000X
-----------------------------------------------------
Taxonomy Name | Surgery Physician
-----------------------------------------------------
License Number | 031122
-----------------------------------------------------
License Number State | GA
-----------------------------------------------------