Provider Demographics
NPI:1487651469
Name:CHEERAN, DAVID C (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:C
Last Name:CHEERAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1415 PORTLAND AVE
Mailing Address - Street 2:SUITE 240
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14621-3038
Mailing Address - Country:US
Mailing Address - Phone:585-544-6550
Mailing Address - Fax:585-338-2997
Practice Address - Street 1:1415 PORTLAND AVE
Practice Address - Street 2:SUITE 240
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14621-3038
Practice Address - Country:US
Practice Address - Phone:585-544-6550
Practice Address - Fax:585-338-2997
Is Sole Proprietor?:No
Enumeration Date:2005-07-05
Last Update Date:2021-05-11
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Provider Licenses
StateLicense IDTaxonomies
NY148925208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1045207Medicaid
NYB72203Medicare UPIN
10650EMedicare PIN