Provider Demographics
NPI:1063696094
Name:CHAE, GIL-YOUNG (DO)
Entity type:Individual
Prefix:DR
First Name:GIL-YOUNG
Middle Name:
Last Name:CHAE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 CORK DR
Mailing Address - Street 2:
Mailing Address - City:GREER
Mailing Address - State:SC
Mailing Address - Zip Code:29650-0973
Mailing Address - Country:US
Mailing Address - Phone:864-561-3213
Mailing Address - Fax:
Practice Address - Street 1:10 CORK DR
Practice Address - Street 2:
Practice Address - City:GREER
Practice Address - State:SC
Practice Address - Zip Code:29650-0973
Practice Address - Country:US
Practice Address - Phone:864-561-3213
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-27
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1125207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FC0155665OtherDEA