Provider Demographics
NPI:1750379434
Name:SHERMAN, STUART A (MD)
Entity type:Individual
Prefix:DR
First Name:STUART
Middle Name:A
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 1:36 TAMARACK AVE, PMB 118
Mailing Address - Street 2:
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06811
Mailing Address - Country:US
Mailing Address - Phone:203-739-7532
Mailing Address - Fax:203-796-7667
Practice Address - Street 1:24 HOSPITAL AVE
Practice Address - Street 2:
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06810-6099
Practice Address - Country:US
Practice Address - Phone:203-739-7532
Practice Address - Fax:203-796-7667
Is Sole Proprietor?:No
Enumeration Date:2005-10-07
Last Update Date:2012-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0328172085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT300001381Medicare PIN
NY300136369Medicare PIN
F53613Medicare UPIN
CT300003617Medicare PIN
NY49H981Medicare PIN
CT300064466Medicare PIN