Provider Demographics
NPI:1346228343
Name:RYTER-BROWN, SHERRY M (MD)
Entity Type:Individual
Prefix:
First Name:SHERRY
Middle Name:M
Last Name:RYTER-BROWN
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:PO BOX 60447
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0447
Mailing Address - Country:US
Mailing Address - Phone:336-992-2340
Mailing Address - Fax:
Practice Address - Street 1:490 PINEVIEW DR
Practice Address - Street 2:SUITE A
Practice Address - City:KERNERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27284-3994
Practice Address - Country:US
Practice Address - Phone:336-992-2340
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-09
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200201403207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89137FUMedicaid
BR8347759OtherFEDERAL DEA
2029380Medicare ID - Type Unspecified
I10217Medicare UPIN