Provider Demographics
NPI:1366207870
Name:SHERVIN, ADEL (MD)
Entity type:Individual
Prefix:
First Name:ADEL
Middle Name:
Last Name:SHERVIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 PILL HILL LN
Mailing Address - Street 2:
Mailing Address - City:DUXBURY
Mailing Address - State:MA
Mailing Address - Zip Code:02332-5007
Mailing Address - Country:US
Mailing Address - Phone:857-400-1415
Mailing Address - Fax:
Practice Address - Street 1:18 PILL HILL LN
Practice Address - Street 2:
Practice Address - City:DUXBURY
Practice Address - State:MA
Practice Address - Zip Code:02332-5007
Practice Address - Country:US
Practice Address - Phone:857-400-1415
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-14
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.081643207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology