MEDICARE: GREGORY SCOTT CHEATHAM MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	23538	AL
2	208M00000X	Hospitalist Physician	MD.23538	AL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1003844754
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GREGORY SCOTT CHEATHAM MD

Provider Business Mailing Address
First Line	:	PO BOX 5689
Second Line	:	1813 BELTLINE ROAD SW
City	:	DECATUR
State	:	AL
Zip	:	35601-0689
Country	:	US
Telephone Number	:	256-353-6874
Fax Number	:	256-353-6876

Provider Business Practice Location Address
First Line	:	1813 BELTLINE RD SW
Second Line	:
City	:	DECATUR
State	:	AL
Zip	:	35601-5506
Country	:	US
Telephone Number	:	256-353-6874
Fax Number	:	256-353-6876

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/30/2006
Last Update Date	:	10/02/2025

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