Healthcare Provider Details

I. General information

NPI: 1306577549
Provider Name (Legal Business Name): CAITLIN FOLEY BERNARDO DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CAITLIN ASHLEY FOLEY

II. Dates (important events)

Enumeration Date: 06/20/2022
Last Update Date: 12/05/2024
Certification Date: 12/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

169 ASHLEY AVE
CHARLESTON SC
29425-8905
US

IV. Provider business mailing address

169 ASHLEY AVE RM 202
CHARLESTON SC
29425-8905
US

V. Phone/Fax

Practice location:
  • Phone: 843-792-1414
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License NumberLL87719
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: