MEDICARE: SHERIE H. AUSTIN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	0101252462	VA
2	208000000X	Pediatrics Physician	0101252462	VA
3	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1013150622
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHERIE H. AUSTIN M.D.

Provider Business Mailing Address
First Line	:	PO BOX 800
Second Line	:
City	:	GLOUCESTER
State	:	VA
Zip	:	23061-0800
Country	:	US
Telephone Number	:	804-695-0305
Fax Number	:	804-695-0804

Provider Business Practice Location Address
First Line	:	8264 GEORGE WASHINGTON MEMORIAL HWY
Second Line	:
City	:	GLOUCESTER
State	:	VA
Zip	:	23061-4127
Country	:	US
Telephone Number	:	804-695-0305
Fax Number	:	804-695-0804

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/13/2009
Last Update Date	:	02/10/2017

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