Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | MA64347 | NJ |
NPI | 1124019930 |
---|---|
Provider Name | Dr. Michael Bruce Sherman |
First Address | Marlboro, NJ 07746-1595 |
Second Address | Hazlet, NJ 07730-1663 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/10/2005 |
Last Update Date | 13/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
7008503 | (05) | NJ |
F92720 | (02) |