Provider Demographics
NPI:1336145986
Name:MCSHERRY, KEVIN J (MD)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:J
Last Name:MCSHERRY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:MORRISTOWN MEMORIAL HOSPITAL
Mailing Address - Street 2:100 MADISON AVE.
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07962
Mailing Address - Country:US
Mailing Address - Phone:973-971-6000
Mailing Address - Fax:
Practice Address - Street 1:100 MADISON AVE.
Practice Address - Street 2:MORRISTOWN MEMORIAL HOSPITAL - DEPT OF EMERG MEDICINE
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960
Practice Address - Country:US
Practice Address - Phone:973-971-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA05487000208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0390500Medicaid
NJ0390500Medicaid
NJCO9454Medicare UPIN