Provider Demographics
NPI:1639551666
Name:COCKRELL, CHERRY E (MD)
Entity type:Individual
Prefix:DR
First Name:CHERRY
Middle Name:E
Last Name:COCKRELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:12445 DORSETT RD
Mailing Address - Street 2:
Mailing Address - City:MARYLAND HEIGHTS
Mailing Address - State:MO
Mailing Address - Zip Code:63043-3907
Mailing Address - Country:US
Mailing Address - Phone:314-343-4440
Mailing Address - Fax:314-343-4439
Practice Address - Street 1:12445 DORSETT RD
Practice Address - Street 2:
Practice Address - City:MARYLAND HEIGHTS
Practice Address - State:MO
Practice Address - Zip Code:63043-3907
Practice Address - Country:US
Practice Address - Phone:314-343-4440
Practice Address - Fax:314-343-4439
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-25
Last Update Date:2018-07-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO2018008663207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine