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NPI Code Detail

MEDICARE: SHERRI SORTOR-THOMPSON MD

MEDICARE:   SHERRI  SORTOR-THOMPSON  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
1208000000XPediatrics PhysicianMD065053-LPA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2185255PLGOTHERPAMEDICARE - GROUP MEMBER PTAN EFFECTIVE 6-9-10

Other Identifiers

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

General Provider Information

NPI Number : 1750382701
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHERRI SORTOR-THOMPSON MD
Provider Business Mailing Address
First Line : 100 HOSPITAL AVE
Second Line :
City : DU BOIS
State : PA
Zip : 15801-1440
Country : US
Telephone Number : 814-371-2200
Fax Number :
Provider Business Practice Location Address
First Line : 1033 TURNPIKE AVE
Second Line : SUITE 200
City : CLEARFIELD
State : PA
Zip : 16830-3061
Country : US
Telephone Number : 814-768-7618
Fax Number : 814-768-7508
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/02/2005
Last Update Date : 12/12/2022

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