Healthcare Provider Details

I. General information

NPI: 1942648076
Provider Name (Legal Business Name): ANDY CHERN MD, MPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/11/2013
Last Update Date: 10/30/2024
Certification Date: 10/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

302 FIRST ST NW
WASHINGTON DC
20534-5438
US

IV. Provider business mailing address

2585 DANIEL ISLAND DR
DANIEL ISLAND SC
29492-8904
US

V. Phone/Fax

Practice location:
  • Phone: 202-451-7701
  • Fax:
Mailing address:
  • Phone: 317-523-3271
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License Number301760-01
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License Number01074387A
License Number StateIN
# 3
Primary TaxonomyN
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License Number301760-01
License Number StateNY
# 4
Primary TaxonomyY
Taxonomy Code2083P0500X
TaxonomyPreventive Medicine/Occupational Environmental Medicine Physician
License Number86458
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: