Provider Demographics
NPI:1649274218
Name:SHERRERD, PAUL S (MD)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:S
Last Name:SHERRERD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:6751 N 72ND ST
Mailing Address - Street 2:STE 207
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68122-1746
Mailing Address - Country:US
Mailing Address - Phone:402-572-3165
Mailing Address - Fax:402-572-3170
Practice Address - Street 1:6751 N 72ND ST
Practice Address - Street 2:STE 207
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68122-1746
Practice Address - Country:US
Practice Address - Phone:402-572-3165
Practice Address - Fax:402-572-3170
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-10
Last Update Date:2024-07-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NE14446207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47069626013Medicaid
IA984732OtherBCBS PROVIDER NUMBER
NE4243OtherBCBS NUMBER
IA0944652Medicaid
IA0944652Medicaid
NE4243OtherBCBS NUMBER
NE263505Medicare ID - Type UnspecifiedMEDICARE