Basic Information
| Provider Information | |||||||||
| NPI: | 1003189515 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MEJIA | ||||||||
| FirstName: | CHERYL | ||||||||
| MiddleName: | LOURDES | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11350 MCCORMICK RD | ||||||||
| Address2: | EXECUTIVE PLAZA 1, SUITE 501 | ||||||||
| City: | HUNT VALLEY | ||||||||
| State: | MD | ||||||||
| PostalCode: | 210311002 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3016659696 | ||||||||
| FaxNumber: | 2404205715 | ||||||||
| Practice Location | |||||||||
| Address1: | 1150 PROFESSIONAL CT | ||||||||
| Address2: | SUITE P | ||||||||
| City: | HAGERSTOWN | ||||||||
| State: | MD | ||||||||
| PostalCode: | 217404100 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3016659696 | ||||||||
| FaxNumber: | 2404205715 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/14/2012 | ||||||||
| LastUpdateDate: | 02/21/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208100000X | H0080207 | MD | Y | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation |
No ID Information.