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Individual

SHERYL D PACK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1497 W ELK AVE, SUITE 21, ELIZABETHTON, TN 37643-2895
(423) 542-7420
(423) 542-7425
Mailing address
1497 W ELK AVE, SUITE 21, ELIZABETHTON, TN 37643-2895
(423) 542-7420
(423) 542-7425

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
33787
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1598715419
VA
05
3864465
TN
05
3865561
TN
05
3865567
TN
01
4122812
BCBST
TN
Enumeration date
05/11/2006
Last updated
02/21/2017
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