Basic Information
| Provider Information | |||||||||
| NPI: | 1659320224 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CHEROKEE LUNG & SLEEP SPECIALISTS, P.C. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 15 REINHARDT COLLEGE PKWY | ||||||||
| Address2: | SUITE 108 | ||||||||
| City: | CANTON | ||||||||
| State: | GA | ||||||||
| PostalCode: | 301145259 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6784932527 | ||||||||
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| Address1: | 15 REINHARDT COLLEGE PKWY | ||||||||
| Address2: | SUITE 108 | ||||||||
| City: | CANTON | ||||||||
| State: | GA | ||||||||
| PostalCode: | 301145257 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6784932527 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/09/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | GRAVES | ||||||||
| AuthorizedOfficialFirstName: | ANITRA | ||||||||
| AuthorizedOfficialMiddleName: | S | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 6784935824 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RP1001X | 049799 | GA | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease |
No ID Information.