Basic Information
| Provider Information | |||||||||
| NPI: | 1518127687 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PETER | ||||||||
| FirstName: | SHERMA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 460 MALL BVLD | ||||||||
| Address2: | STE.B | ||||||||
| City: | SAVANNAH | ||||||||
| State: | GA | ||||||||
| PostalCode: | 31406 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9126445300 | ||||||||
| FaxNumber: | 9126445260 | ||||||||
| Practice Location | |||||||||
| Address1: | 213 MIMS ROAD | ||||||||
| Address2: | |||||||||
| City: | SYLVANIA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 30467 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9125649285 | ||||||||
| FaxNumber: | 9125642174 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/12/2008 | ||||||||
| LastUpdateDate: | 02/27/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207Q00000X | 066306 | GA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.