Provider Demographics
NPI:1801848999
Name:KENDALL, CHERYL J (MD)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:J
Last Name:KENDALL
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:777 CLEVELAND AVE SW
Mailing Address - Street 2:#400
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30315-7129
Mailing Address - Country:US
Mailing Address - Phone:404-766-3337
Mailing Address - Fax:404-766-1464
Practice Address - Street 1:777 CLEVELAND AVE SW
Practice Address - Street 2:#400
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30315-7129
Practice Address - Country:US
Practice Address - Phone:404-766-3337
Practice Address - Fax:404-766-1464
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2008-07-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA0257732080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00286085VMedicaid
GA819825OtherBLUECROSS/BLUESHIELD
GAD40337Medicare UPIN