Provider Demographics
NPI:1114953684
Name:MICHAEL L SHER MD LLC
Entity Type:Organization
Organization Name:MICHAEL L SHER MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:L
Authorized Official - Last Name:SHER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-920-8001
Mailing Address - Street 1:74 BRICK BLVD
Mailing Address - Street 2:SUITE #115
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08723-7984
Mailing Address - Country:US
Mailing Address - Phone:732-920-8001
Mailing Address - Fax:732-920-8004
Practice Address - Street 1:74 BRICK BLVD
Practice Address - Street 2:SUITE #115
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08723-7984
Practice Address - Country:US
Practice Address - Phone:732-920-8001
Practice Address - Fax:732-920-8004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-24
Last Update Date:2012-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA06793600207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ103373Medicare ID - Type Unspecified