Individual
CHERYL P ENTRESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
58 16TH ST, WHEELING, WV 26003-3660
(304) 234-2116
(304) 234-2030
Mailing address
58 16TH ST, WHEELING, WV 26003-3660
(304) 234-2116
(304) 234-2030
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
09089
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0055318000
—
WV
05
—
0779644
—
OH
01
—
09089D
HEALTH PLAN OF UPPER OH V
—
01
—
55035705705
WV COMPENSATION
WV
01
—
5503570579J26
ANTHEM BCBS
—
Enumeration date
08/09/2005
Last updated
10/18/2007
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