MEDICARE: SHERRY A LOOMAN PA

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	363A00000X	Physician Assistant	2221	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1255387130
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHERRY A LOOMAN PA

Provider Business Mailing Address
First Line	:	PO BOX 751649
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28275-1649
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1114 N MAIN ST
Second Line	:
City	:	SUMMERVILLE
State	:	SC
Zip	:	29483-7326
Country	:	US
Telephone Number	:	843-212-8070
Fax Number	:	843-212-8071

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

Provider Enumeration Date	:	05/25/2006
Last Update Date	:	10/30/2020

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Directions to “ SHERRY A LOOMAN PA” Practice Location

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