Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | MD419759 | PA |
N | 2080P0203X | Pediatric Critical Care Doctor | MD419759 | PA |
Y | 2080P0216X | Pediatric Rheumatologist | MD419759 | PA |
NPI | 1164438016 |
---|---|
Provider Name | David D Sherry |
First Address | Philadelphia, PA 19107-3323 |
Second Address | Philadelphia, PA 19104-4319 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/07/2006 |
Last Update Date | 31/01/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001905753 | (05) | PA |
8953104 | (05) | NJ |
C46612 | (02) | PA |