Individual
MONIQUE M. SHERRILL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1202 GAULT AVE N, FORT PAYNE, AL 35967-3040
(256) 997-3434
Mailing address
906 DRIVER LN NW, FORT PAYNE, AL 35967-8212
(256) 997-3434
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD.33738
AL
261QR1300X
Rural Health Clinic/Center
MD.33738
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000181880
UNISON MEDICAID #
OH
01
—
000000504768
ANTHEM BCBS
—
01
—
001714111
MOUNTAIN STATE BCBS
—
01
—
2124507
MOLINA MEDICAID #
OH
05
—
2124507
—
OH
01
—
310917085071
CARESOURCE MEDICAID #
OH
01
—
370013973
RR MEDICARE
OH
05
—
6700078000
—
WV
Enumeration date
06/09/2006
Last updated
06/20/2025
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