Basic Information
| Provider Information | |||||||||
| NPI: | 1093192023 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HENDRIX | ||||||||
| FirstName: | CHERALYN | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8507 SUMMER SKY DR | ||||||||
| Address2: | |||||||||
| City: | SEVERN | ||||||||
| State: | MD | ||||||||
| PostalCode: | 211443044 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5202943953 | ||||||||
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| Practice Location | |||||||||
| Address1: | 22 S GREENE ST | ||||||||
| Address2: | |||||||||
| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212011544 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4103289878 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/28/2015 | ||||||||
| LastUpdateDate: | 08/26/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/26/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 2086S0102X | D91860 | MD | N | Allopathic & Osteopathic Physicians | Surgery | Surgical Critical Care | 208600000X | D0091860 | MD | Y | Allopathic & Osteopathic Physicians | Surgery |
No ID Information.