Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 2011016770 | MO |
Y | 207X00000X | Orthopaedic Surgeon | C163356 | CA |
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 2011016770 | MO |
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | C163356 | CA |
NPI | 1013184290 |
---|---|
Provider Name | Dr. Seth Lawrence Sherman |
First Address | Stanford, CA 94305-2200 |
Second Address | Stanford, CA 94305-2200 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2008 |
Last Update Date | 13/08/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
152360530 | (02) | MO |