Provider Demographics
NPI:1225243249
Name:GOLDMAN, SHERRY DALE (MD)
Entity Type:Individual
Prefix:DR
First Name:SHERRY
Middle Name:DALE
Last Name:GOLDMAN
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 1:11404 OLD GEORGETOWN RD
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-2865
Mailing Address - Country:US
Mailing Address - Phone:301-881-0855
Mailing Address - Fax:301-881-0855
Practice Address - Street 1:11404 OLD GEORGETOWN RD
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-2865
Practice Address - Country:US
Practice Address - Phone:301-881-0855
Practice Address - Fax:301-881-0855
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD288632084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Not Answered2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry