Healthcare Provider Details

I. General information

NPI: 1700854577
Provider Name (Legal Business Name): ABRAHAM ALAN CHERRICK MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/09/2006
Last Update Date: 07/26/2021
Certification Date: 07/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6355 WALKER LN STE 507
ALEXANDRIA VA
22310-3251
US

IV. Provider business mailing address

11350 MCCORMICK RD EXECUTIVE PLAZA 1, STE. 501
HUNT VALLEY MD
21031
US

V. Phone/Fax

Practice location:
  • Phone: 703-738-4332
  • Fax: 703-642-3487
Mailing address:
  • Phone: 703-738-4332
  • Fax: 703-642-1876

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number0101035230
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number0101035230
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: