Provider Demographics
NPI:1194163063
Name:CHERN, CASEY MARIE (MD)
Entity type:Individual
Prefix:DR
First Name:CASEY
Middle Name:MARIE
Last Name:CHERN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:776 DANIEL ELLIS DR
Mailing Address - Street 2:STE 1A
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29412-3095
Mailing Address - Country:US
Mailing Address - Phone:843-723-6529
Mailing Address - Fax:843-723-0424
Practice Address - Street 1:776 DANIEL ELLIS DR STE 1A
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29412-3095
Practice Address - Country:US
Practice Address - Phone:843-723-6529
Practice Address - Fax:843-723-0424
Is Sole Proprietor?:No
Enumeration Date:2013-06-12
Last Update Date:2021-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD83443207N00000X
TYPE 1 NPI NUMBER390200000X
SCMD85178207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program