MEDICARE: DR. STEWART ELLIOTT SHERMAN D.C.

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	111N00000X	Chiropractor	3090	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	030574863	OTHER	SC	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1497778070
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEWART ELLIOTT SHERMAN D.C.

Provider Business Mailing Address
First Line	:	200 W HARRISON ST
Second Line	:	SUITE D
City	:	DILLON
State	:	SC
Zip	:	29536-3331
Country	:	US
Telephone Number	:	843-632-1551
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 W HARRISON ST
Second Line	:	SUITE D
City	:	DILLON
State	:	SC
Zip	:	29536-3331
Country	:	US
Telephone Number	:	843-632-1551
Fax Number	:

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

Provider Enumeration Date	:	07/25/2006
Last Update Date	:	02/16/2011

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