Provider Demographics
NPI:1043416134
Name:PHILIP A. SHERMAN, M.D.
Entity Type:Organization
Organization Name:PHILIP A. SHERMAN, M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:A
Authorized Official - Last Name:SHERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:731-886-1252
Mailing Address - Street 1:1720 E REELFOOT AVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:UNION CITY
Mailing Address - State:TN
Mailing Address - Zip Code:38261-6047
Mailing Address - Country:US
Mailing Address - Phone:731-886-1252
Mailing Address - Fax:731-886-1261
Practice Address - Street 1:1720 E REELFOOT AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:UNION CITY
Practice Address - State:TN
Practice Address - Zip Code:38261-6047
Practice Address - Country:US
Practice Address - Phone:731-886-1252
Practice Address - Fax:731-886-1261
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN14467261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1184623464OtherPHILIP SHERMAN, NPI #
TN1619977584OtherRENEA TERRELL NPI #
TN3373774Medicaid
TNP41832Medicare UPIN
TN3373774Medicaid
TNB04730Medicare UPIN
TN3908134Medicare ID - Type UnspecifiedRENEA TERRELL
TN3196904Medicare ID - Type UnspecifiedPHILIP SHERMAN