Provider Demographics
NPI:1811211766
Name:SHERMAN, VICTOR L (MD)
Entity Type:Individual
Prefix:DR
First Name:VICTOR
Middle Name:L
Last Name:SHERMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1029 CIELO AZUL ST
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87501-1607
Mailing Address - Country:US
Mailing Address - Phone:214-923-1550
Mailing Address - Fax:707-988-7359
Practice Address - Street 1:1029 CIELO AZUL ST
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87501-1607
Practice Address - Country:US
Practice Address - Phone:214-923-1550
Practice Address - Fax:707-988-7359
Is Sole Proprietor?:No
Enumeration Date:2010-03-22
Last Update Date:2014-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMD2010-0587207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXD10428754Medicaid