Healthcare Provider Details

I. General information

NPI: 1396997698
Provider Name (Legal Business Name): DR. MARTIN M CASAREZ
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/17/2008
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 PINCKNEY BLVD
BEAUFORT SC
29902-6122
US

IV. Provider business mailing address

1 PINCKNEY BLVD
BEAUFORT SC
29902-6122
US

V. Phone/Fax

Practice location:
  • Phone: 843-228-5994
  • Fax:
Mailing address:
  • Phone: 843-228-5994
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2008025530
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: