Provider Demographics
NPI:1861059461
Name:SHERMAN, DANIEL P (PA-C)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:P
Last Name:SHERMAN
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43165 THISTLEDOWN TER APT 241
Mailing Address - Street 2:
Mailing Address - City:BROADLANDS
Mailing Address - State:VA
Mailing Address - Zip Code:20148-4075
Mailing Address - Country:US
Mailing Address - Phone:703-405-4122
Mailing Address - Fax:
Practice Address - Street 1:43165 THISTLEDOWN TER APT 241
Practice Address - Street 2:
Practice Address - City:BROADLANDS
Practice Address - State:VA
Practice Address - Zip Code:20148-4075
Practice Address - Country:US
Practice Address - Phone:703-405-4122
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-20
Last Update Date:2019-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0110840241363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical