Provider Demographics
NPI:1013980895
Name:CHERRILL, DAVID A (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:A
Last Name:CHERRILL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:AKDHC
Mailing Address - Street 2:3003 N CENTRAL AVENUE, STE 400
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85012-0000
Mailing Address - Country:US
Mailing Address - Phone:602-997-0484
Mailing Address - Fax:602-944-6882
Practice Address - Street 1:AKDHC
Practice Address - Street 2:7331 E OSBORN DR, STE 150
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-6420
Practice Address - Country:US
Practice Address - Phone:480-994-1238
Practice Address - Fax:480-994-9649
Is Sole Proprietor?:No
Enumeration Date:2006-02-10
Last Update Date:2007-08-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ8828207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ224642Medicaid
AZC99263Medicare UPIN
AZ224642Medicaid