Provider Demographics
NPI:1609903269
Name:SHERER FAMILY MEDICINE, PC
Entity Type:Organization
Organization Name:SHERER FAMILY MEDICINE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP
Authorized Official - Prefix:DR
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:SHERER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:812-683-9020
Mailing Address - Street 1:7240 S US HIGHWAY 231
Mailing Address - Street 2:
Mailing Address - City:HUNTINGBURG
Mailing Address - State:IN
Mailing Address - Zip Code:47542-9450
Mailing Address - Country:US
Mailing Address - Phone:812-683-9020
Mailing Address - Fax:812-683-9024
Practice Address - Street 1:7240 S US HIGHWAY 231
Practice Address - Street 2:
Practice Address - City:HUNTINGBURG
Practice Address - State:IN
Practice Address - Zip Code:47542-9450
Practice Address - Country:US
Practice Address - Phone:812-683-9020
Practice Address - Fax:812-683-9024
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN50004627A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
219390OtherMEDICARE GROUP
IN200373300Medicaid