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General NPI Number Information
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NPI Number | 1962809509
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Entity Type | Organization
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Legal Business Name | CHEROKEE PEDIATRICS
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Dates
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Enumeration Date | 11/25/2014
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Last Update Date | 11/25/2014
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Provider Practice Location Address
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Address Line | 1419 N LIMESTONE ST
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City | GAFFNEY
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State | SC
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Zip | 29340-4748
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Country | US
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Telephone | 864-839-4325
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Fax | 803-839-9901
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Provider Business Mailing Address
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Address Line | 301 W PINE ST
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City | BLACKSBURG
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State | SC
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Zip | 29702-1549
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Country | US
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Telephone | 864-839-4325
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Fax | 864-839-9901
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | DR. DAREN EDWARD CARLING
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Credential | MD
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Telephone | 864-839-4325
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number | 19092
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License Number State | SC
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