Basic Information
| Provider Information | |||||||||
| NPI: | 1447312814 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FOX | ||||||||
| FirstName: | SHERMAN | ||||||||
| MiddleName: | SOL | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1030 UPPER DUMMERSTON RD | ||||||||
| Address2: | |||||||||
| City: | BRATTLEBORO | ||||||||
| State: | VT | ||||||||
| PostalCode: | 053018814 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7813024746 | ||||||||
| FaxNumber: | 7813024635 | ||||||||
| Practice Location | |||||||||
| Address1: | 65 NEWBURY ST | ||||||||
| Address2: | |||||||||
| City: | DANVERS | ||||||||
| State: | MA | ||||||||
| PostalCode: | 019231040 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9787506828 | ||||||||
| FaxNumber: | 9787506684 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/14/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0005X | 159298 | MA | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurodevelopmental Disabilities | 2084P0005X | 6027 | NH | N | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurodevelopmental Disabilities | 2084P0005X | 0008042 | VT | N | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurodevelopmental Disabilities |
ID Information
| ID | Type | State | Issuer | Description | 1001038 | 05 | VT | MEDICAID |