Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207QA0401X | Family Doctor - Addiction Medicine | 0334 | SC |
Y | 207QG0300X | Family Doctor - Geriatric Medicine | 0334 | SC |
NPI | 1629050794 |
---|---|
Provider Name | Dr. Richard Lawrence Sherman |
First Address | Greenville, SC 29610-4611 |
Second Address | Greenville, SC 29615-4191 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/11/2005 |
Last Update Date | 23/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
003445 | (05) | SC |
D20077 | (02) |