Provider Demographics
NPI:1497749543
Name:SHERRATT, AMANDA J (MD)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:J
Last Name:SHERRATT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2150 W CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43606-3846
Mailing Address - Country:US
Mailing Address - Phone:419-291-5599
Mailing Address - Fax:419-291-6445
Practice Address - Street 1:2150 W CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43606-3846
Practice Address - Country:US
Practice Address - Phone:419-291-5599
Practice Address - Fax:419-291-6445
Is Sole Proprietor?:No
Enumeration Date:2005-09-06
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35083579208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000362309OtherANTHEM
OH2551877Medicaid
000000548781OtherANTHEM
25-21266OtherUHC
47701OtherHPM
7914700OtherAETNA
OH046798OtherPHC
OH000000362309OtherANTHEM
000000548781OtherANTHEM
OHSH4155161Medicare ID - Type Unspecified