Individual
MR. CHARLES DONALD SHERRARD JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
200 ABRAHAM FLEXNOR WAY, LOUISVILLE, KY 40202-1821
(502) 587-4421
(502) 361-9947
Mailing address
5454 NEW CUT RD, STE 5, LOUISVILLE, KY 40214-4271
(502) 361-9900
(502) 361-9947
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
24279
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000057678
ANTHEM GROUP NUMBER
KY
01
—
029882600
FEDERAL BLACK LUNG GROUP
—
01
—
1063865
PASSPORT
KY
05
—
200206770A
—
IN
05
—
64242795
—
KY
01
—
930059277
RAILROAD MEDICARE
—
Enumeration date
01/09/2006
Last updated
06/14/2012
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