Provider Demographics
NPI:1497936819
Name:SHERROD, RONALD MICHAEL (DC)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:MICHAEL
Last Name:SHERROD
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1599 W RIVER RD N
Mailing Address - Street 2:
Mailing Address - City:ELYRIA
Mailing Address - State:OH
Mailing Address - Zip Code:44035-2779
Mailing Address - Country:US
Mailing Address - Phone:440-324-9000
Mailing Address - Fax:440-324-2849
Practice Address - Street 1:230 MARKET DR
Practice Address - Street 2:
Practice Address - City:ELYRIA
Practice Address - State:OH
Practice Address - Zip Code:44035-2886
Practice Address - Country:US
Practice Address - Phone:440-324-9000
Practice Address - Fax:440-324-2849
Is Sole Proprietor?:No
Enumeration Date:2007-11-15
Last Update Date:2013-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC27169111N00000X
OH4024111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3043496Medicaid
4290181Medicare UPIN