Provider Demographics
NPI:1851408058
Name:SHERRILL, PIERCE MCCAMMON (DO)
Entity Type:Individual
Prefix:DR
First Name:PIERCE
Middle Name:MCCAMMON
Last Name:SHERRILL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:PETER
Other - Middle Name:MCCAMMON
Other - Last Name:SHERRILL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3237 VOYAGER DR
Mailing Address - Street 2:
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54311-8349
Mailing Address - Country:US
Mailing Address - Phone:920-288-8100
Mailing Address - Fax:920-468-3114
Practice Address - Street 1:3237 VOYAGER DRIVE
Practice Address - Street 2:
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54311
Practice Address - Country:US
Practice Address - Phone:920-288-8100
Practice Address - Fax:920-468-3114
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI26489208100000X, 2083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI30021100Medicaid
WI30021100Medicaid
WI30021100Medicaid
WI30021100Medicaid