Provider Demographics
NPI:1548546567
Name:WHEATON, SHERRY M (MD)
Entity type:Individual
Prefix:DR
First Name:SHERRY
Middle Name:M
Last Name:WHEATON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SHERRY
Other - Middle Name:M
Other - Last Name:STANLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:824 TIMBERLAKE CT
Mailing Address - Street 2:
Mailing Address - City:KETTERING
Mailing Address - State:OH
Mailing Address - Zip Code:45429-3494
Mailing Address - Country:US
Mailing Address - Phone:937-824-0841
Mailing Address - Fax:513-275-3262
Practice Address - Street 1:7792 MISTY SHORE DR
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:OH
Practice Address - Zip Code:45069-9645
Practice Address - Country:US
Practice Address - Phone:937-885-7163
Practice Address - Fax:513-275-3262
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-24
Last Update Date:2015-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH047936207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine