Healthcare Provider Details

I. General information

NPI: 1043290091
Provider Name (Legal Business Name): CHERYL ELAINE WINCHELL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/17/2006
Last Update Date: 07/20/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19241 MONTGOMERY VILLAGE AVE E-10
MONTGOMERY VILLAGE MD
20886-5024
US

IV. Provider business mailing address

19241 MONTGOMERY VILLAGE AVE E-10
MONTGOMERY VILLAGE MD
20886-5024
US

V. Phone/Fax

Practice location:
  • Phone: 301-926-4222
  • Fax: 301-926-4224
Mailing address:
  • Phone: 301-926-4222
  • Fax: 301-926-4224

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberD14555
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: