Provider Demographics
NPI:1447360557
Name:SHERWOOD, EUGENE FRANK (DPM)
Entity type:Individual
Prefix:
First Name:EUGENE
Middle Name:FRANK
Last Name:SHERWOOD
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1260 NILLES RD
Mailing Address - Street 2:BLDG A-1
Mailing Address - City:FAIRFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45014-2912
Mailing Address - Country:US
Mailing Address - Phone:513-829-6232
Mailing Address - Fax:513-829-8973
Practice Address - Street 1:1260 NILLES RD
Practice Address - Street 2:BLDG A-1
Practice Address - City:FAIRFIELD
Practice Address - State:OH
Practice Address - Zip Code:45014-2912
Practice Address - Country:US
Practice Address - Phone:513-829-6232
Practice Address - Fax:513-829-8973
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2009-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH360020965213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
480034775OtherRR MEDICARE
OH0516838Medicaid
OH0530023Medicare PIN
OH0516838Medicaid