Provider Demographics
NPI:1225155120
Name:SHERARD, WILLIAM H (DC)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:H
Last Name:SHERARD
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2625 STEPHEN DR NE
Mailing Address - Street 2:
Mailing Address - City:PALM BAY
Mailing Address - State:FL
Mailing Address - Zip Code:32905-2550
Mailing Address - Country:US
Mailing Address - Phone:321-724-9637
Mailing Address - Fax:
Practice Address - Street 1:1900 PALM BAY RD NE
Practice Address - Street 2:SUITE C
Practice Address - City:PALM BAY
Practice Address - State:FL
Practice Address - Zip Code:32905-2955
Practice Address - Country:US
Practice Address - Phone:321-724-1545
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-23
Last Update Date:2007-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH2678111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL88123Medicare ID - Type Unspecified