Provider Demographics
NPI:1114955473
Name:JORDAN-SAYLES, CHERYL D (MD)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:D
Last Name:JORDAN-SAYLES
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 1:4620 S LABURNUM AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23231-2424
Mailing Address - Country:US
Mailing Address - Phone:804-652-2200
Mailing Address - Fax:804-222-0458
Practice Address - Street 1:4620 S LABURNUM AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23231-2424
Practice Address - Country:US
Practice Address - Phone:804-652-2200
Practice Address - Fax:804-222-0458
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2009-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101043484207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA080125348OtherRAILROAD MEDICARE
VA45893OtherSENTARA
VA005611911Medicaid
VA4118782OtherAETNA LIFE
VA294471OtherMAMSI
VA1428973OtherCIGNA
VA333715OtherANTHEM BCBS OF VA
VA4118782OtherAETNA HMO
VA79150OtherSOUTHERN HEALTH SERVICES
VA1428973OtherCIGNA
VA4118782OtherAETNA LIFE