MEDICARE: MRS. SHERYL CABALZA CHIARIELLO PA-C

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	363A00000X	Physician Assistant	004023	GA
2	367H00000X	Anesthesiologist Assistant	004023	GA

General Provider Information

NPI Number	:	1871675496
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SHERYL CABALZA CHIARIELLO PA-C

Provider Business Mailing Address
First Line	:	790 CLEMONT DR NE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30306-3633
Country	:	US
Telephone Number	:	770-845-4401
Fax Number	:

Provider Business Practice Location Address
First Line	:	5665 NEW NORTHSIDE DR STE 320
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30328-5834
Country	:	US
Telephone Number	:	770-874-6873
Fax Number	:

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

Provider Enumeration Date	:	10/20/2006
Last Update Date	:	10/05/2016

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Directions to “ MRS. SHERYL CABALZA CHIARIELLO PA-C” Practice Location

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