Individual
CHERYL GATEWOOD TOLLIVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2225 US HIGHWAY 41 N, TIFTON, GA 31794-2749
(229) 391-4100
(229) 391-4508
Mailing address
907 E 18TH STREET, SUITE 400, TIFTON, GA 31794
(229) 353-3422
(229) 353-6060
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
053040
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
102002
BCBS - EAPC
GA
01
—
37BBGMH
MEDICARE ID PEDIATRICS
GA
01
—
52002201
BCBS - LMAC
GA
05
—
752710901A
—
GA
01
—
7688493
AETNA
GA
01
—
P00051346
RR MCARE
GA
Enumeration date
08/31/2006
Last updated
07/21/2022
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