Provider Demographics
NPI:1629189196
Name:ORTEL, CHERYL DANIELS (MD)
Entity Type:Individual
Prefix:DR
First Name:CHERYL
Middle Name:DANIELS
Last Name:ORTEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:CHERYL
Other - Middle Name:LYNNE
Other - Last Name:DANIELS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:598 CYNWOOD DR
Mailing Address - Street 2:SUITE 103
Mailing Address - City:EASTON
Mailing Address - State:MD
Mailing Address - Zip Code:21601-3805
Mailing Address - Country:US
Mailing Address - Phone:410-820-7040
Mailing Address - Fax:410-820-9268
Practice Address - Street 1:598 CYNWOOD DR
Practice Address - Street 2:SUITE 103
Practice Address - City:EASTON
Practice Address - State:MD
Practice Address - Zip Code:21601-3805
Practice Address - Country:US
Practice Address - Phone:410-820-7040
Practice Address - Fax:410-820-9268
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2014-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0036272207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD077921100Medicaid
MD1275644700OtherPRACTICE NPI
MD1629189196OtherPERSONAL NPI
MD373M513FMedicare ID - Type Unspecified
MDF09456Medicare UPIN