Healthcare Provider Details

I. General information

NPI: 1649365487
Provider Name (Legal Business Name): CHERRY B. LOBATON MD, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 01/19/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1004 SUSHRUTA DR STE D
MARTINSBURG WV
25401-8898
US

IV. Provider business mailing address

1004 SUSHRUTA DR STE D
MARTINSBURG WV
25401-8898
US

V. Phone/Fax

Practice location:
  • Phone: 304-262-2538
  • Fax: 304-262-2583
Mailing address:
  • Phone: 304-262-2538
  • Fax: 304-262-2583

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. CHERRY B. LOBATON
Title or Position: OWNER
Credential: MD
Phone: 304-262-2538