Provider Demographics
NPI:1801848163
Name:SMITH, SHERREE S (DPM)
Entity Type:Individual
Prefix:DR
First Name:SHERREE
Middle Name:S
Last Name:SMITH
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 COURT ST
Mailing Address - Street 2:STE 3
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360-8710
Mailing Address - Country:US
Mailing Address - Phone:508-747-1973
Mailing Address - Fax:508-747-5392
Practice Address - Street 1:116 COURT ST
Practice Address - Street 2:STE 3
Practice Address - City:PLYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02360-8710
Practice Address - Country:US
Practice Address - Phone:508-747-1973
Practice Address - Fax:508-747-5392
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2152213ES0103X, 213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0339521Medicaid
MAAA1441OtherHPHC
MAY71105OtherBC BS
471398OtherTUFTS
471398OtherTUFTS
MAAA1441OtherHPHC