Provider Demographics
NPI:1003189515
Name:MEJIA, CHERYL LOURDES (DO)
Entity Type:Individual
Prefix:DR
First Name:CHERYL
Middle Name:LOURDES
Last Name:MEJIA
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Gender:F
Credentials:DO
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Mailing Address - Street 1:11350 MCCORMICK RD
Mailing Address - Street 2:EXECUTIVE PLAZA 1, SUITE 501
Mailing Address - City:HUNT VALLEY
Mailing Address - State:MD
Mailing Address - Zip Code:21031-1002
Mailing Address - Country:US
Mailing Address - Phone:301-665-9696
Mailing Address - Fax:240-420-5715
Practice Address - Street 1:1150 PROFESSIONAL CT
Practice Address - Street 2:SUITE P
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740-4100
Practice Address - Country:US
Practice Address - Phone:301-665-9696
Practice Address - Fax:240-420-5715
Is Sole Proprietor?:No
Enumeration Date:2012-02-14
Last Update Date:2017-02-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDH0080207208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation