Provider Demographics
NPI:1003878463
Name:GSTALDER-CHANEY, SHERYL L (DPM)
Entity type:Individual
Prefix:
First Name:SHERYL
Middle Name:L
Last Name:GSTALDER-CHANEY
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1709 KY ROUTE 321 STE 3
Mailing Address - Street 2:
Mailing Address - City:PRESTONSBURG
Mailing Address - State:KY
Mailing Address - Zip Code:41653-9097
Mailing Address - Country:US
Mailing Address - Phone:606-886-8546
Mailing Address - Fax:606-886-8548
Practice Address - Street 1:420 TOM FAZIER WAY
Practice Address - Street 2:
Practice Address - City:SALYERSVILLE
Practice Address - State:KY
Practice Address - Zip Code:41465
Practice Address - Country:US
Practice Address - Phone:606-349-5126
Practice Address - Fax:606-349-5123
Is Sole Proprietor?:No
Enumeration Date:2006-04-03
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY241213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY80002413Medicaid
U73458Medicare UPIN