Provider Demographics
NPI:1588656276
Name:SHERRY, RICHARD LESLIE (MD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:LESLIE
Last Name:SHERRY
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2500 GRUBB RD
Mailing Address - Street 2:SUITE 234
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19810-4799
Mailing Address - Country:US
Mailing Address - Phone:302-475-6500
Mailing Address - Fax:302-475-9528
Practice Address - Street 1:2500 GRUBB RD
Practice Address - Street 2:SUITE 234
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19810-4799
Practice Address - Country:US
Practice Address - Phone:302-475-6500
Practice Address - Fax:302-475-9528
Is Sole Proprietor?:No
Enumeration Date:2005-08-18
Last Update Date:2008-08-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
DEC10002810207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0000097201Medicaid
DED01198Medicare UPIN
DE0000097201Medicaid