Provider Demographics
NPI:1427238328
Name:CASE, CHRISTINE A (MD)
Entity type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:A
Last Name:CASE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:9221 UNIVERSITY BLVD
Mailing Address - Street 2:SUITE 2E
Mailing Address - City:NORTH CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29406-9148
Mailing Address - Country:US
Mailing Address - Phone:843-572-5001
Mailing Address - Fax:843-572-9636
Practice Address - Street 1:9221 UNIVERSITY BLVD
Practice Address - Street 2:SUITE 2E
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29406-9148
Practice Address - Country:US
Practice Address - Phone:843-572-5001
Practice Address - Fax:843-572-9636
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-07
Last Update Date:2007-11-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC11389207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC11389Medicaid
SCGP0472Medicaid
SC3903Medicare PIN
SCC60737Medicare UPIN