MEDICARE: CHERYL ANTIONETTE SAVAGE REGISTERED NURSE

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	163W00000X	Registered Nurse	R111683	MD

General Provider Information

NPI Number	:	1831482967
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHERYL ANTIONETTE SAVAGE REGISTERED NURSE

Provider Business Mailing Address
First Line	:	5429 PRICE AVE
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21215-4532
Country	:	US
Telephone Number	:	443-742-3078
Fax Number	:

Provider Business Practice Location Address
First Line	:	5429 PRICE AVE
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21215-4532
Country	:	US
Telephone Number	:	443-742-3078
Fax Number	:

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

Provider Enumeration Date	:	05/23/2011
Last Update Date	:	05/23/2011

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