Provider Demographics
NPI:1457353195
Name:JON M SHERMAN D.P.M PC
Entity type:Organization
Organization Name:JON M SHERMAN D.P.M PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JON
Authorized Official - Middle Name:M
Authorized Official - Last Name:SHERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:301-330-5666
Mailing Address - Street 1:60 MARKET ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20878-6548
Mailing Address - Country:US
Mailing Address - Phone:301-330-5666
Mailing Address - Fax:301-330-8971
Practice Address - Street 1:60 MARKET ST
Practice Address - Street 2:SUITE 202
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20878-6548
Practice Address - Country:US
Practice Address - Phone:301-330-5666
Practice Address - Fax:301-330-8971
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-12
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01326213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDG01262Medicare PIN
U82815Medicare UPIN
MD4835070001Medicare ID - Type Unspecified
MD4835070001Medicare NSC
MD00B919J62Medicare PIN