Provider Demographics
NPI:1639144090
Name:SHERRILL, CHERYL A (PA-C)
Entity Type:Individual
Prefix:MS
First Name:CHERYL
Middle Name:A
Last Name:SHERRILL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:CHERYL
Other - Middle Name:A
Other - Last Name:HOPKINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:PO BOX 415348
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-0001
Mailing Address - Country:US
Mailing Address - Phone:800-225-8885
Mailing Address - Fax:508-334-1977
Practice Address - Street 1:281 LINCOLN ST
Practice Address - Street 2:DEPARTMENT OF PLASTIC & COSMETIC SURGERY
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01605-2138
Practice Address - Country:US
Practice Address - Phone:508-856-5299
Practice Address - Fax:508-334-5152
Is Sole Proprietor?:No
Enumeration Date:2006-02-21
Last Update Date:2020-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA523363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAS66031Medicare UPIN
MAAP144301Medicare PIN