Provider Demographics
NPI:1407996820
Name:SHERMAN, LAWRENCE M (MD)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:M
Last Name:SHERMAN
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 1:1173 SHERIDAN DR
Mailing Address - Street 2:
Mailing Address - City:TONAWANDA
Mailing Address - State:NY
Mailing Address - Zip Code:14150-7930
Mailing Address - Country:US
Mailing Address - Phone:716-907-2222
Mailing Address - Fax:815-327-9366
Practice Address - Street 1:1173 SHERIDAN DR
Practice Address - Street 2:
Practice Address - City:TONAWANDA
Practice Address - State:NY
Practice Address - Zip Code:14150-7930
Practice Address - Country:US
Practice Address - Phone:716-907-2222
Practice Address - Fax:815-327-9366
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2013-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY129824207P00000X, 2083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY129824-9WOtherWORKERS COMPENSATION
NY078561Medicaid
NY078561Medicaid
NY129824-9WOtherWORKERS COMPENSATION