Provider Demographics
NPI:1851142699
Name:LI, CHERYL (DPM)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:
Last Name:LI
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:868 MAN O WAR BLVD
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:KY
Mailing Address - Zip Code:41091-8067
Mailing Address - Country:US
Mailing Address - Phone:908-745-1860
Mailing Address - Fax:
Practice Address - Street 1:1970 ROANOKE BOULEVARD
Practice Address - Street 2:PODIATRY SERVICES
Practice Address - City:SALEM
Practice Address - State:VA
Practice Address - Zip Code:24153
Practice Address - Country:US
Practice Address - Phone:540-982-2463
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-29
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program