Provider Demographics
NPI:1265148316
Name:SHERROD, TYRONE
Entity type:Individual
Prefix:
First Name:TYRONE
Middle Name:
Last Name:SHERROD
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 1:325 KENDRICK DR
Mailing Address - Street 2:
Mailing Address - City:ABERDEEN
Mailing Address - State:MD
Mailing Address - Zip Code:21001-2352
Mailing Address - Country:US
Mailing Address - Phone:443-787-8557
Mailing Address - Fax:
Practice Address - Street 1:325 KENDRICK DR
Practice Address - Street 2:
Practice Address - City:ABERDEEN
Practice Address - State:MD
Practice Address - Zip Code:21001-2352
Practice Address - Country:US
Practice Address - Phone:443-787-8557
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-23
Last Update Date:2024-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator