MEDICARE: DR. EDDIE RAYMOND CHEEKS M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	21661	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1184640898
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EDDIE RAYMOND CHEEKS M.D.

Provider Business Mailing Address
First Line	:	85 CONIFER CIR
Second Line	:
City	:	AUGUSTA
State	:	GA
Zip	:	30909-4508
Country	:	US
Telephone Number	:	706-736-2737
Fax Number	:	706-731-9047

Provider Business Practice Location Address
First Line	:	2803 WRIGHTSBORO RD
Second Line	:	SUITE 45
City	:	AUGUSTA
State	:	GA
Zip	:	30909-3913
Country	:	US
Telephone Number	:	706-736-2737
Fax Number	:	706-731-9047

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/14/2006
Last Update Date	:	07/21/2022

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