Basic Information
| Provider Information | |||||||||
| NPI: | 1114119708 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FERGUSON | ||||||||
| FirstName: | SHERRY | ||||||||
| MiddleName: | A. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 320 LOCUST TER | ||||||||
| Address2: | |||||||||
| City: | SALISBURY | ||||||||
| State: | MD | ||||||||
| PostalCode: | 218015307 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3015188516 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 9730 HEALTHWAY DRIVE | ||||||||
| Address2: | BERLIN HEALTH CENTER | ||||||||
| City: | BERLIN | ||||||||
| State: | MD | ||||||||
| PostalCode: | 21811 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4106290164 | ||||||||
| FaxNumber: | 4106290185 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/16/2007 | ||||||||
| LastUpdateDate: | 08/16/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 171M00000X | MD | Y | Other Service Providers | Case Manager/Care Coordinator |
No ID Information.