Provider Demographics
NPI:1437479896
Name:JERIG, SEAN NATHANIEL (MD)
Entity Type:Individual
Prefix:
First Name:SEAN
Middle Name:NATHANIEL
Last Name:JERIG
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 1:1319 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:OH
Mailing Address - Zip Code:43130-4005
Mailing Address - Country:US
Mailing Address - Phone:740-687-2229
Mailing Address - Fax:740-687-2220
Practice Address - Street 1:1319 E MAIN ST
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:OH
Practice Address - Zip Code:43130-4005
Practice Address - Country:US
Practice Address - Phone:740-687-2229
Practice Address - Fax:740-687-2220
Is Sole Proprietor?:No
Enumeration Date:2010-06-08
Last Update Date:2022-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10037521207V00000X
UT9065004-1205207V00000X
OH35.133175207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology