Provider Demographics
NPI:1982684452
Name:SHERMAN, STEVEN ANTHONY (MD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:ANTHONY
Last Name:SHERMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:777 KIMOLE LN
Mailing Address - Street 2:SUITE 210
Mailing Address - City:ADRIAN
Mailing Address - State:MI
Mailing Address - Zip Code:49221-1478
Mailing Address - Country:US
Mailing Address - Phone:517-264-5115
Mailing Address - Fax:517-265-5312
Practice Address - Street 1:777 KIMOLE LN
Practice Address - Street 2:SUITE 210
Practice Address - City:ADRIAN
Practice Address - State:MI
Practice Address - Zip Code:49221-1479
Practice Address - Country:US
Practice Address - Phone:517-264-5115
Practice Address - Fax:517-265-5312
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-19
Last Update Date:2021-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI304632084N0400X
MI43010440112084N0600X, 2084N0400X
MI9272084N0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical Neurophysiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
0P60200OtherPTAN
MIM019033OtherCHAMPUS/TRICARE
MI0461117OtherBCBS OF MICHIGAN
MI130004288OtherRAILROAD MEDICARE
MI1419261OtherUNITED MINE WORKERS
MI2667315Medicaid
38291755600OtherOHIO BUREAU OF WORKERS CO
MI3995740OtherCIGNA
MI4515856OtherAETNA
MI1419261OtherUNITED MINE WORKERS
38291755600OtherOHIO BUREAU OF WORKERS CO