Provider Demographics
NPI:1336300433
Name:LAW, CHERYL M (MD)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:M
Last Name:LAW
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:2800 ALLISON BONNETT MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:HUEYTOWN
Mailing Address - State:AL
Mailing Address - Zip Code:35023-1845
Mailing Address - Country:US
Mailing Address - Phone:205-744-4410
Mailing Address - Fax:205-744-6150
Practice Address - Street 1:2800 ALLISON BONNETT MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:HUEYTOWN
Practice Address - State:AL
Practice Address - Zip Code:35023-1845
Practice Address - Country:US
Practice Address - Phone:205-744-4410
Practice Address - Fax:205-744-6150
Is Sole Proprietor?:No
Enumeration Date:2008-06-20
Last Update Date:2011-08-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SCLL31005207Q00000X
AL31043207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL130771/133630043Medicaid
AL130771/133630043Medicaid