Provider Demographics
NPI:1477781995
Name:PIERRE, SHERVON A (MD)
Entity type:Individual
Prefix:
First Name:SHERVON
Middle Name:A
Last Name:PIERRE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:455 LAKESHORE PARKWAY
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29730-4205
Mailing Address - Country:US
Mailing Address - Phone:803-581-0574
Mailing Address - Fax:803-581-5898
Practice Address - Street 1:455 LAKESHORE PARKWAY
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29730-4205
Practice Address - Country:US
Practice Address - Phone:803-581-0574
Practice Address - Fax:803-581-5898
Is Sole Proprietor?:No
Enumeration Date:2009-06-23
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2012-02034207Q00000X
SC39896207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCNC2257Medicaid