Provider Demographics
NPI:1447244264
Name:SHERMAN, JAMES CARMICHAEL (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:CARMICHAEL
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 1:1430 HARPER ST
Mailing Address - Street 2:BUILDING B
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30901-0617
Mailing Address - Country:US
Mailing Address - Phone:706-724-5451
Mailing Address - Fax:706-724-9562
Practice Address - Street 1:501 BLACKBURN DR
Practice Address - Street 2:
Practice Address - City:MARTINEZ
Practice Address - State:GA
Practice Address - Zip Code:30907-8201
Practice Address - Country:US
Practice Address - Phone:706-854-8340
Practice Address - Fax:706-854-8341
Is Sole Proprietor?:No
Enumeration Date:2005-09-08
Last Update Date:2020-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA031122208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCG31122Medicaid
SCG31122Medicaid
02BDBWVMedicare PIN