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Individual
CHERYL A ENNIS
Active
Individual
CHERYL A ENNIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
10783
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01Y002477NH01
BC/BS
NH
01
—
079963
TUFTS
—
01
—
22542240
TRICARE/CHAMPUS
—
01
—
24483
CIGNA
—
05
—
30204275
—
NH
01
—
351677
HARVARD HEALTH
—
01
—
783909
MVP
—
Enumeration date
08/25/2005
Last updated
09/19/2012
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