MEDICARE: JOHN A 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
1	207P00000X	Emergency Medicine Physician	MD00043900	WA
2	207P00000X	Emergency Medicine Physician	5450A	WY
3	207P00000X	Emergency Medicine Physician	12638	HI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0174377	OTHER	WA	LIWA
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	4968SH	OTHER	WA	BSWA
4	2165SH	OTHER	WA	BSWA
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	1186SH	OTHER	WA	BSWA
7	0174392	OTHER	WA	LIWA
8	0174745	OTHER	WA	LIWA
9	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
10	314488	OTHER	WY	BSWY

General Provider Information

NPI Number	:	1730185497
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN A SHERMAN MD

Provider Business Mailing Address
First Line	:	505 S 336TH STREET
Second Line	:	SUITE 600
City	:	FEDERAL WAY
State	:	WA
Zip	:	98003-6328
Country	:	US
Telephone Number	:	253-838-6180
Fax Number	:	253-838-6418

Provider Business Practice Location Address
First Line	:	1200 COLLEGE DRIVE
Second Line	:
City	:	ROCK SPRINGS
State	:	WY
Zip	:	82901-5838
Country	:	US
Telephone Number	:	307-352-8350
Fax Number	:	307-352-8178

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

Provider Enumeration Date	:	06/27/2005
Last Update Date	:	05/03/2012

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Directions to “ JOHN A SHERMAN MD” Practice Location

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