Provider Demographics
NPI:1407948458
Name:WHERRY, SEAN PATRICK (MD)
Entity Type:Individual
Prefix:DR
First Name:SEAN
Middle Name:PATRICK
Last Name:WHERRY
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1360 ELM STREET EAST
Mailing Address - Street 2:CENTRACARE CLINIC ST JOSEPH FAMILY MEDICINE
Mailing Address - City:ST JOSEPH
Mailing Address - State:MN
Mailing Address - Zip Code:56374-4694
Mailing Address - Country:US
Mailing Address - Phone:320-363-7765
Mailing Address - Fax:320-363-0031
Practice Address - Street 1:1360 ELM STREET EAST
Practice Address - Street 2:CENTRACARE CLINIC ST JOSEPH FAMILY MEDICINE
Practice Address - City:ST JOSEPH
Practice Address - State:MN
Practice Address - Zip Code:56374-4694
Practice Address - Country:US
Practice Address - Phone:320-363-7765
Practice Address - Fax:320-363-0031
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2023-03-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
171000000X
MN108778207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No171000000XOther Service ProvidersMilitary Health Care Provider