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General NPI Number Information
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NPI Number | 1194163063
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Entity Type | Individual
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Provider Name | CASEY MARIE CHERN MD
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Gender | Female
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Dates
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Enumeration Date | 06/12/2013
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Last Update Date | 09/27/2021
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Provider Practice Location Address
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Address Line | 776 DANIEL ELLIS DR STE 1A
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City | CHARLESTON
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State | SC
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Zip | 29412-3095
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Country | US
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Telephone | 843-723-6529
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Fax | 843-723-0424
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Provider Business Mailing Address
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Address Line | 776 DANIEL ELLIS DR STE 1A
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City | CHARLESTON
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State | SC
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Zip | 29412-3095
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Country | US
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Telephone | 843-723-6529
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Fax | 843-723-0424
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | D83443
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | TYPE 1 NPI NUMBER
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | MD85178
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License Number State | SC
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