Provider Demographics
NPI:1427026178
Name:ANDERSON SHERMAN, JUDITH A (MD)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:A
Last Name:ANDERSON SHERMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JUDITH
Other - Middle Name:ANN
Other - Last Name:SHERMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:110 METKER TRAIL
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40484-1020
Mailing Address - Country:US
Mailing Address - Phone:606-365-3360
Mailing Address - Fax:606-365-9378
Practice Address - Street 1:110 METKER TRL
Practice Address - Street 2:
Practice Address - City:STANFORD
Practice Address - State:KY
Practice Address - Zip Code:40484-1020
Practice Address - Country:US
Practice Address - Phone:606-365-3360
Practice Address - Fax:606-365-9378
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036063124207Q00000X
KY00374207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100454830Medicaid
ILC45846Medicare UPIN