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General NPI Number Information
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NPI Number | 1750873618
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Entity Type | Individual
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Provider Name | BENJAMIN ANDREW CASOLA MD
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Gender | Male
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Dates
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Enumeration Date | 06/05/2018
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Last Update Date | 11/19/2025
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Provider Practice Location Address
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Address Line | 6650 RIVERS AVE STE 100
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City | NORTH CHARLESTON
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State | SC
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Zip | 29406-4809
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Country | US
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Telephone | 845-590-4873
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Fax |
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Provider Business Mailing Address
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Address Line | 11945 GRANDHAVEN DR STE E
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City | MURRELLS INLET
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State | SC
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Zip | 29576-8091
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Country | US
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Telephone | 843-995-9025
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Fax | 843-310-1311
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 87780
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License Number State | SC
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