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Individual

JUAN JOSE SHERWOOD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
150 MEDICAL BLVD, SUITE B, STOCKBRIDGE, GA 30281-5053
(770) 389-9944
(770) 389-1973
Mailing address
150 MEDICAL BLVD, SUITE B, STOCKBRIDGE, GA 30281-5053
(770) 389-9944
(770) 389-1973

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
032470
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000413993A
GA
05
000413993B
GA
05
000413993D
GA
01
0110001605
HEALTH SOURCE
01
0526682
AETNA SELECT / US HEALTHC
01
1202577
UNITED HEALTHCARE
01
276714
BCBS
01
581487734
PROMINA CLAIMS
01
581487734002
PRUCARE
01
7802
KAISER POS
01
S06119
SC HEALTHSOURCE
Enumeration date
08/03/2005
Last updated
09/30/2011
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