Provider Demographics
NPI:1467615187
Name:CHERYL WINCHELL, M.D., P.A.
Entity Type:Organization
Organization Name:CHERYL WINCHELL, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:ELAINE
Authorized Official - Last Name:WINCHELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-926-4222
Mailing Address - Street 1:19241 MONTGOMERY VILLAGE AVE
Mailing Address - Street 2:SUITE E 10
Mailing Address - City:MONTGOMERY VILLAGE
Mailing Address - State:MD
Mailing Address - Zip Code:20886-5024
Mailing Address - Country:US
Mailing Address - Phone:301-926-4222
Mailing Address - Fax:301-926-4224
Practice Address - Street 1:19241 MONTGOMERY VILLAGE AVE
Practice Address - Street 2:SUITE E 10
Practice Address - City:MONTGOMERY VILLAGE
Practice Address - State:MD
Practice Address - Zip Code:20886-5024
Practice Address - Country:US
Practice Address - Phone:301-926-4222
Practice Address - Fax:301-926-4224
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-02
Last Update Date:2008-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD14555207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD188071300Medicaid
B93992Medicare UPIN
171141Medicare PIN