Provider Demographics
NPI:1740689181
Name:SHERMAN, DAVID (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:
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 1:2801 NW 23RD BLVD
Mailing Address - Street 2:APT N95
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32605-5937
Mailing Address - Country:US
Mailing Address - Phone:660-233-2209
Mailing Address - Fax:
Practice Address - Street 1:8350 STATE ROUTE 30
Practice Address - Street 2:
Practice Address - City:DITTMER
Practice Address - State:MO
Practice Address - Zip Code:63023-1909
Practice Address - Country:US
Practice Address - Phone:314-392-3822
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-21
Last Update Date:2019-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME130343207Y00000X, 2084A0401X
MO20160374472084A0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084A0401XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Medicine
No207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLJC419YOtherMEDICARE
MO2016037447OtherSTATE OF MISSOURI PHYSICIAN AND SURGEON