Provider Demographics
NPI:1740449198
Name:SHERK, YAKOV (MD)
Entity type:Individual
Prefix:DR
First Name:YAKOV
Middle Name:
Last Name:SHERK
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 1:750 CROSS POINTE RD STE D
Mailing Address - Street 2:
Mailing Address - City:GAHANNA
Mailing Address - State:OH
Mailing Address - Zip Code:43230-6692
Mailing Address - Country:US
Mailing Address - Phone:614-768-2700
Mailing Address - Fax:937-998-1118
Practice Address - Street 1:750 CROSS POINTE RD STE D
Practice Address - Street 2:
Practice Address - City:GAHANNA
Practice Address - State:OH
Practice Address - Zip Code:43230-6692
Practice Address - Country:US
Practice Address - Phone:614-768-2700
Practice Address - Fax:937-998-1118
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-02
Last Update Date:2022-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.1277202084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0180303Medicaid
OH0180303Medicaid