Basic Information
| Provider Information | |||||||||
| NPI: | 1861570350 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SHERMAN | ||||||||
| FirstName: | DAVID | ||||||||
| MiddleName: | M | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 100 15TH AVE | ||||||||
| Address2: | #180 | ||||||||
| City: | SOUTH MILWAUKEE | ||||||||
| State: | WI | ||||||||
| PostalCode: | 531721160 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4147685430 | ||||||||
| FaxNumber: | 4147624225 | ||||||||
| Practice Location | |||||||||
| Address1: | 2000 E LAYTON AVE | ||||||||
| Address2: | #100 | ||||||||
| City: | ST FRANCIS | ||||||||
| State: | WI | ||||||||
| PostalCode: | 53235 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4147446589 | ||||||||
| FaxNumber: | 4147478848 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/01/2006 | ||||||||
| LastUpdateDate: | 11/22/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/22/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 40375 | WI | Y | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.