Provider Demographics
NPI:1275679433
Name:EADS, CHERYL ANNETTE (MD)
Entity Type:Individual
Prefix:DR
First Name:CHERYL
Middle Name:ANNETTE
Last Name:EADS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 238
Mailing Address - Street 2:
Mailing Address - City:JEFFERSONVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47131-0238
Mailing Address - Country:US
Mailing Address - Phone:502-741-5722
Mailing Address - Fax:
Practice Address - Street 1:887 N GARDNER ST STE A
Practice Address - Street 2:
Practice Address - City:SCOTTSBURG
Practice Address - State:IN
Practice Address - Zip Code:47170-1457
Practice Address - Country:US
Practice Address - Phone:502-741-5722
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY379002080N0001X
IN01062940A2080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine