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General NPI Number Information
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NPI Number | 1700801578
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Entity Type | Individual
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Provider Name | CHERRY ANN WY M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/13/2006
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Last Update Date | 02/03/2022
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Provider Practice Location Address
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Address Line | 1144 COFFEE RD
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City | MODESTO
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State | CA
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Zip | 95355-4205
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Country | US
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Telephone | 209-524-1211
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 255228
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City | SACRAMENTO
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State | CA
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Zip | 95865-5228
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Country | US
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Telephone | 191-670-8803
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Fax | 855-202-9336
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080N0001X
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Taxonomy Name | Neonatal-Perinatal Medicine Physician
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License Number | A70518
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | A70518
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License Number State | CA
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