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Individual

CHERYL A CONETSCO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
2326 18TH ST, STE 210, COLUMBUS, IN 47201
(812) 372-8426
(812) 372-8301
Mailing address
2326 18TH ST, STE 210, COLUMBUS, IN 47201
(812) 372-8426
(812) 372-8301

Taxonomy

Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
02002736A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000329870
ANTHEM
01
1790837789
GROUP NPI
IN
05
200482230
IN
01
40647
SIHO
01
P00249217
MEDICARE RAILROAD
Enumeration date
06/27/2006
Last updated
05/08/2012
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