Provider Demographics
NPI:1194706911
Name:SWADER, SHERI L (MD)
Entity type:Individual
Prefix:
First Name:SHERI
Middle Name:L
Last Name:SWADER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SHERI
Other - Middle Name:L
Other - Last Name:SWADER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:101 W NORTHSIDE DR # F
Mailing Address - Street 2:
Mailing Address - City:VALDOSTA
Mailing Address - State:GA
Mailing Address - Zip Code:31602-1714
Mailing Address - Country:US
Mailing Address - Phone:229-262-1981
Mailing Address - Fax:229-375-0392
Practice Address - Street 1:101F W NORTHSIDE DR
Practice Address - Street 2:
Practice Address - City:VALDOSTA
Practice Address - State:GA
Practice Address - Zip Code:31602-1700
Practice Address - Country:US
Practice Address - Phone:229-262-1981
Practice Address - Fax:229-375-0392
Is Sole Proprietor?:No
Enumeration Date:2005-11-09
Last Update Date:2020-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL248942084N0400X
GA802442084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009998375Medicaid
AL51001503OtherBCBS OF AL
GA003208546CMedicaid
AL009998375Medicaid
AL51001503OtherBCBS OF AL