Organization
CHERAWEN GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHERYL MCCLAIN MD (MANAGER)
(859) 229-1225
Entity
Organization
Contact information
Practice address
4060 TROY PIKE, VERSAILLES, KY 40383-8924
(859) 229-1225
Mailing address
4060 TROY PIKE, VERSAILLES, KY 40383-8924
(859) 229-1225
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207QA0401X
Addiction Medicine (Family Medicine) Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0157267726
CORPORATE BUSINESS ID
KY
Enumeration date
06/30/2020
Last updated
07/03/2023
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