Provider Demographics
NPI:1336149707
Name:SHER, MICHAEL LAURENCE (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:LAURENCE
Last Name:SHER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:74 BRICK BLVD
Mailing Address - Street 2:SUITE 115
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08723-7984
Mailing Address - Country:US
Mailing Address - Phone:732-920-8001
Mailing Address - Fax:732-920-8004
Practice Address - Street 1:74 BRICK BLVD
Practice Address - Street 2:SUITE 115
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08723-7984
Practice Address - Country:US
Practice Address - Phone:732-920-8001
Practice Address - Fax:732-920-8004
Is Sole Proprietor?:No
Enumeration Date:2005-07-28
Last Update Date:2012-08-31
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA06793600207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G48098Medicare UPIN
NJ017227Medicare ID - Type Unspecified