Provider Demographics
NPI:1265735393
Name:SHERMAN, JERALD JACOB (MD)
Entity type:Individual
Prefix:
First Name:JERALD
Middle Name:JACOB
Last Name:SHERMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1520 JOHNSON FERRY RD
Mailing Address - Street 2:SUITE145
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30062
Mailing Address - Country:US
Mailing Address - Phone:404-252-7805
Mailing Address - Fax:770-509-0487
Practice Address - Street 1:1520 JOHNSON FERRY RD
Practice Address - Street 2:SUITE145
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30062
Practice Address - Country:US
Practice Address - Phone:404-252-7805
Practice Address - Fax:770-509-0487
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-12
Last Update Date:2010-12-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA10382207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAD46281Medicare UPIN