Provider Demographics
NPI:1750667051
Name:SHERCHAN, MAMTA (MD)
Entity Type:Individual
Prefix:
First Name:MAMTA
Middle Name:
Last Name:SHERCHAN
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 1:2221 NOLL DR STE 2000
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17603-7614
Mailing Address - Country:US
Mailing Address - Phone:717-715-1001
Mailing Address - Fax:717-431-2321
Practice Address - Street 1:2221 NOLL DR STE 2000
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17603-7614
Practice Address - Country:US
Practice Address - Phone:717-715-1001
Practice Address - Fax:717-431-2321
Is Sole Proprietor?:No
Enumeration Date:2011-10-31
Last Update Date:2020-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD471721207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology