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General NPI Number Information
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NPI Number | 1811125909
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Entity Type | Individual
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Provider Name | CHERYL BRADLEY GAMBRELL M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/26/2009
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Last Update Date | 02/20/2025
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Provider Practice Location Address
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Address Line | 4568 SUNSET BLVD
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City | LEXINGTON
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State | SC
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Zip | 29072-9250
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Country | US
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Telephone | 803-520-5144
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Fax | 803-462-0312
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Provider Business Mailing Address
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Address Line | 105 N RAILROAD AVE
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City | LAMAR
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State | SC
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Zip | 29069-9727
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Country | US
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Telephone | 843-420-9690
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Fax | 843-543-6393
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | MD40002
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License Number State | SC
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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 | 0101251800
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | 0116021830
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License Number State | VA
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