Provider Demographics
NPI:1447312814
Name:FOX, SHERMAN SOL (MD)
Entity type:Individual
Prefix:DR
First Name:SHERMAN
Middle Name:SOL
Last Name:FOX
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1030 UPPER DUMMERSTON RD
Mailing Address - Street 2:
Mailing Address - City:BRATTLEBORO
Mailing Address - State:VT
Mailing Address - Zip Code:05301-8814
Mailing Address - Country:US
Mailing Address - Phone:781-302-4746
Mailing Address - Fax:781-302-4635
Practice Address - Street 1:65 NEWBURY ST
Practice Address - Street 2:
Practice Address - City:DANVERS
Practice Address - State:MA
Practice Address - Zip Code:01923-1040
Practice Address - Country:US
Practice Address - Phone:978-750-6828
Practice Address - Fax:978-750-6684
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1592982084P0005X
NH60272084P0005X
VT00080422084P0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0005XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurodevelopmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1001038Medicaid
MAFOA29346Medicare ID - Type Unspecified
C65976Medicare UPIN
VT1001038Medicaid