Provider Demographics
NPI:1982662425
Name:SHERMAN, GLENN ALAN (DO)
Entity Type:Individual
Prefix:DR
First Name:GLENN
Middle Name:ALAN
Last Name:SHERMAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8885 STATE ROAD 237
Mailing Address - Street 2:
Mailing Address - City:TELL CITY
Mailing Address - State:IN
Mailing Address - Zip Code:47586-8567
Mailing Address - Country:US
Mailing Address - Phone:812-547-7011
Mailing Address - Fax:
Practice Address - Street 1:105 S 2ND ST
Practice Address - Street 2:
Practice Address - City:ROCKPORT
Practice Address - State:IN
Practice Address - Zip Code:47635-1318
Practice Address - Country:US
Practice Address - Phone:812-649-2271
Practice Address - Fax:812-649-4867
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN02001335A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100225000Medicaid
IN100225000AMedicaid
KY64022890Medicaid