Provider Demographics
NPI:1508810805
Name:HECHT, CHERYL L (MD)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:L
Last Name:HECHT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2550 WINDY HILL RD SE
Mailing Address - Street 2:SUITE 115
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30067-8665
Mailing Address - Country:US
Mailing Address - Phone:770-980-1818
Mailing Address - Fax:770-980-1873
Practice Address - Street 1:2550 WINDY HILL RD SE
Practice Address - Street 2:SUITE 115
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30067-8665
Practice Address - Country:US
Practice Address - Phone:770-980-1818
Practice Address - Fax:770-980-1873
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2010-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA034155174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAC74813Medicare UPIN
GA00470093AMedicare ID - Type Unspecified