Provider Demographics
NPI:1346273364
Name:SHERRER, CARL W (MD)
Entity Type:Individual
Prefix:
First Name:CARL
Middle Name:W
Last Name:SHERRER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:77 COLLIER RD NW STE 2010
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-1754
Mailing Address - Country:US
Mailing Address - Phone:404-355-6600
Mailing Address - Fax:404-352-0657
Practice Address - Street 1:77 COLLIER RD NW STE 2010
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-1754
Practice Address - Country:US
Practice Address - Phone:404-355-6600
Practice Address - Fax:404-352-0657
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9900675207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCBCBSOther128KW
D30800Medicare UPIN
NC2279584Medicare ID - Type Unspecified