Provider Demographics
NPI:1063504710
Name:REINHARDT, CHERYL (MD)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:
Last Name:REINHARDT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 975
Mailing Address - Street 2:
Mailing Address - City:SHANNON
Mailing Address - State:GA
Mailing Address - Zip Code:30172-0975
Mailing Address - Country:US
Mailing Address - Phone:706-295-1184
Mailing Address - Fax:706-236-1919
Practice Address - Street 1:5865 NEW CALHOUN HWY NE
Practice Address - Street 2:
Practice Address - City:ROME
Practice Address - State:GA
Practice Address - Zip Code:30161-8253
Practice Address - Country:US
Practice Address - Phone:706-295-1184
Practice Address - Fax:706-236-1919
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2013-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK25079207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine