Provider Demographics
NPI:1861448045
Name:SHERMAN, JOHN A (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:A
Last Name:SHERMAN
Suffix:
Gender:M
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:PO BOX 550
Mailing Address - Street 2:
Mailing Address - City:MANNING
Mailing Address - State:SC
Mailing Address - Zip Code:29102-0550
Mailing Address - Country:US
Mailing Address - Phone:803-435-8463
Mailing Address - Fax:803-435-3196
Practice Address - Street 1:10 HOSPITAL ST.
Practice Address - Street 2:
Practice Address - City:MANNING
Practice Address - State:SC
Practice Address - Zip Code:29102-0550
Practice Address - Country:US
Practice Address - Phone:803-435-8463
Practice Address - Fax:803-435-3196
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2019-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2009-01637207L00000X
CAC160944207L00000X
SC18233207L00000X
GA71875207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC182331Medicaid
SCG23358Medicare UPIN
SC7763Medicare ID - Type UnspecifiedGROUP NUMBER