Provider Demographics
NPI:1073572210
Name:SHERFEY, SHANNON H (MD)
Entity Type:Individual
Prefix:
First Name:SHANNON
Middle Name:H
Last Name:SHERFEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:767 W 1ST ST
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:NC
Mailing Address - Zip Code:28658-4238
Mailing Address - Country:US
Mailing Address - Phone:828-465-3928
Mailing Address - Fax:828-465-3118
Practice Address - Street 1:767 W 1ST ST
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:NC
Practice Address - Zip Code:28658-4238
Practice Address - Country:US
Practice Address - Phone:828-465-3928
Practice Address - Fax:828-465-3118
Is Sole Proprietor?:No
Enumeration Date:2006-03-17
Last Update Date:2014-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200101132207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0229NOtherBCBS GRP NUMBER
NC89134F8Medicaid
NC890229NMedicaid
NY310993406OtherCIGNA GRP NUMBER
NCP00269962OtherRAILROAD MEDICARE
NC2000525FMedicare PIN
NY310993406OtherCIGNA GRP NUMBER