Provider Demographics
NPI:1003025974
Name:SHERER, ROBERT J (OD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:J
Last Name:SHERER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:DR
Other - First Name:ROBERT
Other - Middle Name:J
Other - Last Name:SHERER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PC
Mailing Address - Street 1:3226 10TH AVE S
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59405-3449
Mailing Address - Country:US
Mailing Address - Phone:406-205-3552
Mailing Address - Fax:406-952-0019
Practice Address - Street 1:3226 10TH AVE S
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59405-3449
Practice Address - Country:US
Practice Address - Phone:406-205-3552
Practice Address - Fax:406-952-0019
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2016-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT557152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
27940OtherBCBS
MT0483067Medicaid
MT0483067Medicaid
MTV22404Medicare UPIN
MT0269660001OtherDME JURISDICTION D PTAN
MT0483067Medicaid
MT0269660001Medicare NSC