Provider Demographics
NPI:1962494237
Name:CRUMP, SHERRY (MD)
Entity Type:Individual
Prefix:
First Name:SHERRY
Middle Name:
Last Name:CRUMP
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Middle Name:
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Mailing Address - Street 1:75 PIEDMONT AVE
Mailing Address - Street 2:STE 700
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30303-2544
Mailing Address - Country:US
Mailing Address - Phone:404-756-5271
Mailing Address - Fax:404-756-1402
Practice Address - Street 1:720 WESTVIEW DR SW
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30310-1458
Practice Address - Country:US
Practice Address - Phone:404-752-1541
Practice Address - Fax:404-752-1198
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA0377852083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00763661BMedicaid
H05165Medicare UPIN
GA00763661BMedicaid