Basic Information
| Provider Information | |||||||||
| NPI: | 1649433384 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ROSS | ||||||||
| FirstName: | SHERRY | ||||||||
| MiddleName: | SEDBERRY | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | UNIVERSITY OF NORTH CAROLINA AT CHAPEL HL | ||||||||
| Address2: | 170 MANNING DRIVE, CB 7235 | ||||||||
| City: | CHAPEL HILL | ||||||||
| State: | NC | ||||||||
| PostalCode: | 275997235 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9199627876 | ||||||||
| FaxNumber: | 9198435956 | ||||||||
| Practice Location | |||||||||
| Address1: | 1301 CENTRAL DR | ||||||||
| Address2: | |||||||||
| City: | SANFORD | ||||||||
| State: | NC | ||||||||
| PostalCode: | 273304159 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9197189512 | ||||||||
| FaxNumber: | 9197189516 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/02/2008 | ||||||||
| LastUpdateDate: | 08/10/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 08/10/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2088P0231X | MD035527 | DC | N | Allopathic & Osteopathic Physicians | Urology | Pediatric Urology | 2088P0231X | 2008-01882 | NC | N | Allopathic & Osteopathic Physicians | Urology | Pediatric Urology | 208800000X | 200801882 | NC | Y | Allopathic & Osteopathic Physicians | Urology |
No ID Information.