Provider Demographics
NPI:1104915719
Name:KALB, CHERYL ELLEN (DC)
Entity type:Individual
Prefix:DR
First Name:CHERYL
Middle Name:ELLEN
Last Name:KALB
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 RAIN DROP CIR
Mailing Address - Street 2:
Mailing Address - City:REISTERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21136-3541
Mailing Address - Country:US
Mailing Address - Phone:410-833-8560
Mailing Address - Fax:
Practice Address - Street 1:3333 N CALVERT ST
Practice Address - Street 2:555
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21218-2867
Practice Address - Country:US
Practice Address - Phone:410-261-8531
Practice Address - Fax:410-261-8464
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2009-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDS1595PT111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDU39623Medicare UPIN