Provider Demographics
NPI:1306056395
Name:SAVAGE, SHERRY LYNN (OD)
Entity type:Individual
Prefix:DR
First Name:SHERRY
Middle Name:LYNN
Last Name:SAVAGE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:SHERRY
Other - Middle Name:LYNN
Other - Last Name:SALOOM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:2100 SUMMIT RIDGE PLZ
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:PA
Mailing Address - Zip Code:15666-1969
Mailing Address - Country:US
Mailing Address - Phone:724-542-9792
Mailing Address - Fax:724-542-9793
Practice Address - Street 1:2100 SUMMIT RIDGE PLZ
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:PA
Practice Address - Zip Code:15666-1969
Practice Address - Country:US
Practice Address - Phone:724-542-9792
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2016-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG-002460152W00000X, 152WC0802X, 152WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
No152WP0200XEye and Vision Services ProvidersOptometristPediatrics