Provider Demographics
NPI:1316969546
Name:SHERR, ELIOT G (DPM)
Entity type:Individual
Prefix:DR
First Name:ELIOT
Middle Name:G
Last Name:SHERR
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:DR
Other - First Name:ELIOT
Other - Middle Name:G
Other - Last Name:SHERR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DPM
Mailing Address - Street 1:205 ANDOVER ST
Mailing Address - Street 2:
Mailing Address - City:PEABODY
Mailing Address - State:MA
Mailing Address - Zip Code:01960-1603
Mailing Address - Country:US
Mailing Address - Phone:978-531-4484
Mailing Address - Fax:866-214-2666
Practice Address - Street 1:205 ANDOVER ST
Practice Address - Street 2:
Practice Address - City:PEABODY
Practice Address - State:MA
Practice Address - Zip Code:01960-1603
Practice Address - Country:US
Practice Address - Phone:978-531-4484
Practice Address - Fax:866-214-2666
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-24
Last Update Date:2010-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1497213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY70620OtherBCBS
MAT11304Medicare UPIN
MA0540190001Medicare NSC
MAY70620OtherBCBS