Provider Demographics
NPI:1376893602
Name:FUGET, SHERRI A (LMT)
Entity Type:Individual
Prefix:PROF
First Name:SHERRI
Middle Name:A
Last Name:FUGET
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:PROF
Other - First Name:SHERRI
Other - Middle Name:A
Other - Last Name:PARTRIDGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMT
Mailing Address - Street 1:PO BOX 44264
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21236-6264
Mailing Address - Country:US
Mailing Address - Phone:443-600-7466
Mailing Address - Fax:
Practice Address - Street 1:1124 MACE AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21221
Practice Address - Country:US
Practice Address - Phone:410-238-2292
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-13
Last Update Date:2012-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
173C00000X, 174H00000X
MDM03406225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No173C00000XOther Service ProvidersReflexologist
No174H00000XOther Service ProvidersHealth Educator
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDM03406OtherMARYLAND STATE MASSAGE THERAPY LICENSE