Provider Demographics
NPI:1548239411
Name:WHISENANT, SHERRY A (MD)
Entity Type:Individual
Prefix:DR
First Name:SHERRY
Middle Name:A
Last Name:WHISENANT
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 1:140 W 11TH ST
Mailing Address - Street 2:
Mailing Address - City:FRONT ROYAL
Mailing Address - State:VA
Mailing Address - Zip Code:22630-3512
Mailing Address - Country:US
Mailing Address - Phone:540-631-3700
Mailing Address - Fax:540-635-1673
Practice Address - Street 1:140 W 11TH ST
Practice Address - Street 2:
Practice Address - City:FRONT ROYAL
Practice Address - State:VA
Practice Address - Zip Code:22630-3512
Practice Address - Country:US
Practice Address - Phone:540-631-3700
Practice Address - Fax:540-635-1673
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2009-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101049485207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA077363OtherANTHEM
VA080052763OtherRAILROAD MEDICARE
VA005620333Medicaid
VA080052763OtherRAILROAD MEDICARE
VA077363OtherANTHEM