Provider Demographics
NPI:1215912597
Name:SHERRY, STEVEN PAUL (DO)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:PAUL
Last Name:SHERRY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7927 VANDERBILT DR NW
Mailing Address - Street 2:
Mailing Address - City:NORTH CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44720-5759
Mailing Address - Country:US
Mailing Address - Phone:330-244-0660
Mailing Address - Fax:
Practice Address - Street 1:7927 VANDERBILT DR NW
Practice Address - Street 2:
Practice Address - City:NORTH CANTON
Practice Address - State:OH
Practice Address - Zip Code:44720-5759
Practice Address - Country:US
Practice Address - Phone:330-244-0660
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-09
Last Update Date:2008-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34-00-7821-S207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
H21179Medicare UPIN