Provider Demographics
NPI:1033401898
Name:FREY, CHERI NICOLE (MD)
Entity Type:Individual
Prefix:
First Name:CHERI
Middle Name:NICOLE
Last Name:FREY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CHERI
Other - Middle Name:NICOLE
Other - Last Name:ADGERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2041 GEORGIA AVE NW STE 4300
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20060-0001
Mailing Address - Country:US
Mailing Address - Phone:202-865-6679
Mailing Address - Fax:202-865-5018
Practice Address - Street 1:2041 GEORGIA AVE NW STE 4300
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20060-0001
Practice Address - Country:US
Practice Address - Phone:202-865-6679
Practice Address - Fax:202-865-5018
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-11
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLTRN16055207R00000X
FLME119241207N00000X
DCMD048832207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL015435500Medicaid
MD546978ZXKNOtherMEDICARE
VA546965ZW77OtherMEDICARE