Healthcare Provider Details

I. General information

NPI: 1811960248
Provider Name (Legal Business Name): CHEROKEE PEDIATRIC ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/08/2006
Last Update Date: 10/05/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 W PINE ST
BLACKSBURG SC
29702-1549
US

IV. Provider business mailing address

301 W PINE ST
BLACKSBURG SC
29702-1549
US

V. Phone/Fax

Practice location:
  • Phone: 864-839-4325
  • Fax: 864-839-9901
Mailing address:
  • Phone: 864-839-4325
  • Fax: 864-839-9901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code305R00000X
TaxonomyPreferred Provider Organization
License Number23503
License Number StateSC

VIII. Authorized Official

Name: DR. DAREN E CARLING
Title or Position: OWNER
Credential: M.D.
Phone: 864-839-4325