Provider Demographics
NPI:1881680429
Name:SHERMAN, JEFFREY A (MD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:A
Last Name:SHERMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1280 HIGHWAY 74 S
Mailing Address - Street 2:SUITE 100
Mailing Address - City:PEACHTREE CITY
Mailing Address - State:GA
Mailing Address - Zip Code:30269-3077
Mailing Address - Country:US
Mailing Address - Phone:770-631-1344
Mailing Address - Fax:770-631-7609
Practice Address - Street 1:1280 HIGHWAY 74 SOUTH
Practice Address - Street 2:SUITE 100
Practice Address - City:PEACHTREE CITY
Practice Address - State:GA
Practice Address - Zip Code:30269
Practice Address - Country:US
Practice Address - Phone:770-631-1344
Practice Address - Fax:770-631-0684
Is Sole Proprietor?:No
Enumeration Date:2005-09-20
Last Update Date:2016-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA040785207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA040785OtherMEDICAL LICENSE NUMBER
1447476593OtherGROUP NPI
GA854731OtherBCBS
5429581OtherAETNA/US HEALHCARE
5429581OtherAETNA/US HEALTHCARE HMO
9994013OtherCIGNA
GA854731OtherBCBS
GA08BBSLSMedicare PIN
GA08BBSLSMedicare PIN
5429581OtherAETNA/US HEALHCARE
10033610OtherAMERIGROUP - AMERICAID
GA000755444FMedicaid