MEDICARE: CARL W SHERRER 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
1	207VG0400X	Gynecology Physician	9900675	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	BCBS	OTHER	NC	128KW

General Provider Information

NPI Number	:	1346273364
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARL W SHERRER MD

Provider Business Mailing Address
First Line	:	77 COLLIER RD NW STE 2010
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30309-1754
Country	:	US
Telephone Number	:	404-355-6600
Fax Number	:	404-352-0657

Provider Business Practice Location Address
First Line	:	77 COLLIER RD NW STE 2010
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30309-1754
Country	:	US
Telephone Number	:	404-355-6600
Fax Number	:	404-352-0657

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

Provider Enumeration Date	:	07/10/2006
Last Update Date	:	07/08/2007

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