| NPI | 1962620302 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEROME A SHERARD Sole Proprietor 423-624-3555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Additional Taxonomies | 208D00000X General Practice |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2010-11-19 |