MEDICARE: DR. CHEREE SHANTELL ELDRIDGE DPM

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	213E00000X	Podiatrist	2126	NV
2	213ES0131X	Foot Surgery Podiatrist	001267	GA
3	213E00000X	Podiatrist	001267	GA

General Provider Information

NPI Number	:	1891059887
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHEREE SHANTELL ELDRIDGE DPM

Provider Business Mailing Address
First Line	:	2275 MARIETTA BLVD NW STE 270190
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30318-2004
Country	:	US
Telephone Number	:	404-736-7198
Fax Number	:

Provider Business Practice Location Address
First Line	:	2275 MARIETTA BLVD NW STE 270190
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30318-2004
Country	:	US
Telephone Number	:	404-736-7198
Fax Number	:

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

Provider Enumeration Date	:	06/25/2012
Last Update Date	:	03/11/2026

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