Provider Demographics
NPI:1275644700
Name:CHERYL D. ORTEL, MD PA
Entity Type:Organization
Organization Name:CHERYL D. ORTEL, MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:D
Authorized Official - Last Name:ORTEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-820-7040
Mailing Address - Street 1:598 CYNWOOD DR
Mailing Address - Street 2:SUITE 103
Mailing Address - City:EASTON
Mailing Address - State:MD
Mailing Address - Zip Code:21601-3805
Mailing Address - Country:US
Mailing Address - Phone:410-820-7040
Mailing Address - Fax:410-820-9268
Practice Address - Street 1:598 CYNWOOD DR
Practice Address - Street 2:SUITE 103
Practice Address - City:EASTON
Practice Address - State:MD
Practice Address - Zip Code:21601-3805
Practice Address - Country:US
Practice Address - Phone:410-820-7040
Practice Address - Fax:410-820-9268
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD373MMedicare ID - Type Unspecified