Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 7349 | MT |
Y | 111NI0900X | Internist | 7349 | MT |
N | 207RA0401X | Internist - Addiction Medicine | 7349 | MT |
NPI | 1619076122 |
---|---|
Provider Name | Robert C. Sherrick |
First Address | Kalispell, MT 59901-3146 |
Second Address | Kalispell, MT 59901-3146 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/09/2006 |
Last Update Date | 26/06/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
05531 | BCBS (01) | MT |
110071679 | RR MEDICARE (01) | |
981071 | (05) | MT |
C88594 | (02) |