Provider Demographics
NPI:1942267208
Name:SIAREZI, SHERRY (MD)
Entity type:Individual
Prefix:
First Name:SHERRY
Middle Name:
Last Name:SIAREZI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SHAGHAYEGH
Other - Middle Name:
Other - Last Name:SIYAHREZAEI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1195 OLD HICKORY BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-4239
Mailing Address - Country:US
Mailing Address - Phone:629-230-1988
Mailing Address - Fax:629-230-0288
Practice Address - Street 1:1195 OLD HICKORY BLVD STE 101
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-4239
Practice Address - Country:US
Practice Address - Phone:629-230-1988
Practice Address - Fax:629-230-0288
Is Sole Proprietor?:No
Enumeration Date:2006-04-28
Last Update Date:2025-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD-19290207V00000X
TXM0274207V00000X
TN59872207VG0400X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1681462-05Medicaid