Provider Demographics
NPI:1083835466
Name:DURANT, CHERYL ANTOINETTE (MPT)
Entity type:Individual
Prefix:MS
First Name:CHERYL
Middle Name:ANTOINETTE
Last Name:DURANT
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4604 HELLWIG RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21206-2715
Mailing Address - Country:US
Mailing Address - Phone:443-708-4160
Mailing Address - Fax:
Practice Address - Street 1:9801 BROKENLAND PKWY
Practice Address - Street 2:STE 103
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21046-3080
Practice Address - Country:US
Practice Address - Phone:410-290-8832
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2022-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA38711225100000X
KY04680225100000X
MD19324225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist