Individual
CHERYL H. MITCHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
600 CELEBRATE LIFE PKWY, NEWNAN, GA 30265-8001
(855) 848-5760
Mailing address
600 CELEBRATE LIFE PKWY, NEWNAN, GA 30265-8001
(706) 977-9255
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
003124
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100001172A
—
GA
Enumeration date
10/10/2006
Last updated
06/23/2021
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