Provider Demographics
NPI:1487902250
Name:SHERMAN, BRADLEY M (PHARMD)
Entity type:Individual
Prefix:
First Name:BRADLEY
Middle Name:M
Last Name:SHERMAN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4458 ALBON RD
Mailing Address - Street 2:
Mailing Address - City:MONCLOVA
Mailing Address - State:OH
Mailing Address - Zip Code:43542-9347
Mailing Address - Country:US
Mailing Address - Phone:419-304-1955
Mailing Address - Fax:
Practice Address - Street 1:2770 W BROAD ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43204-2641
Practice Address - Country:US
Practice Address - Phone:614-276-9745
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-27
Last Update Date:2012-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03331426183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist