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NPI Code Detail

MEDICARE: MARY B SHERMAN MD

MEDICARE: MARY B SHERMAN MD
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
1207RG0300XGeriatric Medicine (Internal Medicine) PhysicianG37222CA

General Provider Information

NPI Number : 1083674709
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY B SHERMAN MD
Provider Business Mailing Address
First Line : PO BOX 2685
Second Line :
City : SEAL BEACH
State : CA
Zip : 90740-1685
Country : US
Telephone Number : 562-493-9581
Fax Number :
Provider Business Practice Location Address
First Line : 1661 GOLDEN RAIN RD
Second Line :
City : SEAL BEACH
State : CA
Zip : 90740-4907
Country : US
Telephone Number : 562-493-9581
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/25/2006
Last Update Date : 07/08/2007

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