Provider Demographics
NPI:1346367745
Name:CHERRY, ANGELA D (MD)
Entity Type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:D
Last Name:CHERRY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ANGELA
Other - Middle Name:D
Other - Last Name:OGLESBY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2500 FOUNDATION WAY
Mailing Address - Street 2:
Mailing Address - City:MARTINSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:25401-9000
Mailing Address - Country:US
Mailing Address - Phone:304-264-9202
Mailing Address - Fax:
Practice Address - Street 1:171 TAYLOR STREET
Practice Address - Street 2:
Practice Address - City:HARPERS FERRY
Practice Address - State:WV
Practice Address - Zip Code:25425
Practice Address - Country:US
Practice Address - Phone:304-535-6343
Practice Address - Fax:304-293-6963
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2022-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV22161207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WVP00386368OtherRAILROAD MEDICARE
WV3810008003Medicaid
WVOG6035541Medicare PIN
WV3810008003Medicaid