Provider Demographics
NPI:1720066558
Name:SHERMAN, GLENN S (MD)
Entity Type:Individual
Prefix:
First Name:GLENN
Middle Name:S
Last Name:SHERMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1119 TREELINE DR
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18103-6049
Mailing Address - Country:US
Mailing Address - Phone:484-225-1042
Mailing Address - Fax:610-336-0384
Practice Address - Street 1:222 HIGH ST
Practice Address - Street 2:SUITE 201
Practice Address - City:NEWTON
Practice Address - State:NJ
Practice Address - Zip Code:07860-9604
Practice Address - Country:US
Practice Address - Phone:973-300-3200
Practice Address - Fax:973-579-5777
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-03
Last Update Date:2019-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA058743L207VX0000X
NJ25MA06048700207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007767070002Medicaid
PA1007767070006Medicaid
NJ7636008Medicaid
PA1007767070010Medicaid
PA1007767070005Medicaid
PA001601266Medicaid
PA1007767070002Medicaid
PA1007767070006Medicaid