Provider Demographics
NPI:1831262435
Name:GILMER, SHERRY J (OD)
Entity type:Individual
Prefix:DR
First Name:SHERRY
Middle Name:J
Last Name:GILMER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:SHERRY
Other - Middle Name:L
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:305 GROVE RD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29605-4112
Mailing Address - Country:US
Mailing Address - Phone:864-234-8786
Mailing Address - Fax:864-234-8756
Practice Address - Street 1:3925 PELHAM RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-5004
Practice Address - Country:US
Practice Address - Phone:864-288-8224
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2018-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV006582152W00000X
SC1025152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYU52495Medicare UPIN
SCAA51230281Medicare UPIN