Provider Demographics
NPI:1326198706
Name:SHERMAN, SPENCER DC (DC)
Entity Type:Individual
Prefix:DR
First Name:SPENCER
Middle Name:DC
Last Name:SHERMAN
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 1:200 MAIN ST
Mailing Address - Street 2:SUIT 17
Mailing Address - City:BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05401-8374
Mailing Address - Country:US
Mailing Address - Phone:802-862-2477
Mailing Address - Fax:802-862-2477
Practice Address - Street 1:200 MAIN ST
Practice Address - Street 2:SUIT 17
Practice Address - City:BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05401-8374
Practice Address - Country:US
Practice Address - Phone:802-862-2477
Practice Address - Fax:802-862-2477
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT006-0000987111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
VTSPEN00029734OtherBLUE CROSS BLUE SHIELD
VT428120OtherCIGNA
VTSPEN00029734OtherBLUE CROSS BLUE SHIELD