Basic Information
| Provider Information | |||||||||
| NPI: | 1538176581 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SHERMAN | ||||||||
| FirstName: | FREDERICK | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1127 UNIVERSITY BLVD NE | ||||||||
| Address2: | MSC10 5600 | ||||||||
| City: | ALBUQUERQUE | ||||||||
| State: | NM | ||||||||
| PostalCode: | 871021740 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5052724511 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1127 UNIVERSITY BLVD NE | ||||||||
| Address2: | CARRIE TINGLEY HOSPITAL | ||||||||
| City: | ALBUQUERQUE | ||||||||
| State: | NM | ||||||||
| PostalCode: | 871021740 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5052724511 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/02/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2080S0010X | 76-268 | NM | Y | Allopathic & Osteopathic Physicians | Pediatrics | Sports Medicine |
No ID Information.