Provider Demographics
NPI:1891110847
Name:SHERMAN, NDIKUM
Entity Type:Individual
Prefix:
First Name:NDIKUM
Middle Name:
Last Name:SHERMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11338 EVANS TRL APT T1
Mailing Address - Street 2:
Mailing Address - City:BELTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20705-3020
Mailing Address - Country:US
Mailing Address - Phone:240-505-0129
Mailing Address - Fax:
Practice Address - Street 1:11338 EVANS TRL APT T1
Practice Address - Street 2:
Practice Address - City:BELTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20705-3020
Practice Address - Country:US
Practice Address - Phone:240-505-0129
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-27
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA9545374U00000X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No374U00000XNursing Service Related ProvidersHome Health Aide