Healthcare Provider Details

I. General information

NPI: 1003850355
Provider Name (Legal Business Name): DANIEL A CASKIE PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2006
Last Update Date: 03/14/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8901 UNIVERSITY BLVD
NORTH CHARLESTON SC
29406-9116
US

IV. Provider business mailing address

PO BOX 50520
SUMMERVILLE SC
29485-0520
US

V. Phone/Fax

Practice location:
  • Phone: 843-552-4240
  • Fax: 843-552-4121
Mailing address:
  • Phone: 843-552-4240
  • Fax: 843-552-4121

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code146L00000X
TaxonomyParamedic
License NumberSC015028
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number1314
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: