Provider Demographics
NPI:1508100116
Name:SERMERSHEIM, NATHAN JEROME (DC)
Entity Type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:JEROME
Last Name:SERMERSHEIM
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1285 PARKWAY DR
Mailing Address - Street 2:
Mailing Address - City:ZIONSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46077-1953
Mailing Address - Country:US
Mailing Address - Phone:317-491-1073
Mailing Address - Fax:317-733-3341
Practice Address - Street 1:1285 PARKWAY DR
Practice Address - Street 2:
Practice Address - City:ZIONSVILLE
Practice Address - State:IN
Practice Address - Zip Code:46077-1953
Practice Address - Country:US
Practice Address - Phone:317-491-1073
Practice Address - Fax:317-733-3341
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-20
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08002659A111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation