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NPI Code Detail

MEDICARE: SHERRY S CANTRELL MD

MEDICARE: SHERRY S CANTRELL MD
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
1163W00000XRegistered Nurse71001433AIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1000000502343OTHERINANTHEM
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1811946338
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHERRY S CANTRELL MD
Provider Business Mailing Address
First Line : 8910 PURDUE RD
Second Line : STE 500
City : INDIANAPOLIS
State : IN
Zip : 46268-3161
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1434 SHELBY ST
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46203-1945
Country : US
Telephone Number : 317-655-3200
Fax Number : 317-655-3210
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/10/2006
Last Update Date : 07/22/2011

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Directions to “ SHERRY S CANTRELL MD” Practice Location

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