Provider Demographics
NPI:1164455317
Name:PEIRCE, SHERMAN H (OD)
Entity Type:Individual
Prefix:DR
First Name:SHERMAN
Middle Name:H
Last Name:PEIRCE
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2041 STONEWOOD CT
Mailing Address - Street 2:
Mailing Address - City:SANDY
Mailing Address - State:UT
Mailing Address - Zip Code:84093-6925
Mailing Address - Country:US
Mailing Address - Phone:801-413-9193
Mailing Address - Fax:
Practice Address - Street 1:12357 S 450 E
Practice Address - Street 2:SUITE 2
Practice Address - City:DRAPER
Practice Address - State:UT
Practice Address - Zip Code:84020-8127
Practice Address - Country:US
Practice Address - Phone:801-572-9804
Practice Address - Fax:801-572-9805
Is Sole Proprietor?:No
Enumeration Date:2006-07-09
Last Update Date:2008-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5944605-9934152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
UTV07658Medicare UPIN