Provider Demographics
NPI:1093042996
Name:SHERROD, THERESA T (MD)
Entity Type:Individual
Prefix:DR
First Name:THERESA
Middle Name:T
Last Name:SHERROD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:THERESA
Other - Middle Name:T
Other - Last Name:HOLLAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:8561 FENTON ST
Mailing Address - Street 2:SUITE 250
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-4455
Mailing Address - Country:US
Mailing Address - Phone:240-821-1222
Mailing Address - Fax:240-821-1227
Practice Address - Street 1:8561 FENTON ST
Practice Address - Street 2:SUITE 250
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-4455
Practice Address - Country:US
Practice Address - Phone:240-821-1222
Practice Address - Fax:240-821-1227
Is Sole Proprietor?:No
Enumeration Date:2009-11-13
Last Update Date:2016-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD57860207ZD0900X
MDD0053860207ZD0900X, 207ZP0102X
VA0101032608207ZD0900X, 207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No207ZD0900XAllopathic & Osteopathic PhysiciansPathologyDermatopathology