Provider Demographics
NPI:1851485890
Name:SHERVETTE, ROBERT EDWARD III (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:EDWARD
Last Name:SHERVETTE
Suffix:III
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:223 N ANDERSON DR
Mailing Address - Street 2:P O BOX 1259
Mailing Address - City:SWAINSBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30401-4440
Mailing Address - Country:US
Mailing Address - Phone:478-289-2683
Mailing Address - Fax:478-289-2681
Practice Address - Street 1:223 N ANDERSON DR
Practice Address - Street 2:
Practice Address - City:SWAINSBORO
Practice Address - State:GA
Practice Address - Zip Code:30401-4440
Practice Address - Country:US
Practice Address - Phone:478-289-2683
Practice Address - Fax:478-289-2681
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2010-10-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA0304232084P0804X
SC147382084P0804X
NC324302084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA030423OtherGA LICENSE
NC32430OtherNC LICENSE
SC14738OtherSC LICENSE