Provider Demographics
NPI:1316217482
Name:CANTRELL, CHERYL KAYE (MD)
Entity Type:Individual
Prefix:DR
First Name:CHERYL
Middle Name:KAYE
Last Name:CANTRELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1308 BIRMINGHAM RD
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19382-8204
Mailing Address - Country:US
Mailing Address - Phone:610-793-9202
Mailing Address - Fax:610-793-9202
Practice Address - Street 1:1701 AUGUSTINE CUT OFF
Practice Address - Street 2:SUITE 8
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19803-4415
Practice Address - Country:US
Practice Address - Phone:610-793-9202
Practice Address - Fax:610-793-9202
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-06
Last Update Date:2012-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1-00035052084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry