Basic Information
Provider Information
NPI: 1467495978
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: NAGLE
FirstName: SHERYL
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 64374
Address2:  
City: BALTIMORE
State: MD
PostalCode: 212644374
CountryCode: US
TelephoneNumber: 6672141616
FaxNumber: 4103281674
Practice Location
Address1: 250 W PRATT ST
Address2: SUITE 770
City: BALTIMORE
State: MD
PostalCode: 212012423
CountryCode: US
TelephoneNumber: 6672141616
FaxNumber: 4103281674
Other Information
ProviderEnumerationDate: 06/13/2006
LastUpdateDate: 04/10/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000XD34866MDY Allopathic & Osteopathic PhysiciansAnesthesiology 

ID Information
IDTypeStateIssuerDescription
C1129801MDRAILROAD MEDICARE GROUPOTHER
48666140005MD MEDICAID


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