Basic Information
| Provider Information | |||||||||
| NPI: | 1508820796 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CHERE | ||||||||
| FirstName: | MITCHEL | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 360 N IRBY ST | ||||||||
| Address2: | |||||||||
| City: | FLORENCE | ||||||||
| State: | SC | ||||||||
| PostalCode: | 295012808 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8436679414 | ||||||||
| FaxNumber: | 8436671362 | ||||||||
| Practice Location | |||||||||
| Address1: | 360 N IRBY ST | ||||||||
| Address2: | |||||||||
| City: | FLORENCE | ||||||||
| State: | SC | ||||||||
| PostalCode: | 295012808 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8436679414 | ||||||||
| FaxNumber: | 8436671362 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/14/2006 | ||||||||
| LastUpdateDate: | 01/11/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
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| NPICertificationDate: | 01/11/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 024427 | CT | N | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | 207V00000X | 86988 | SC | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | 181488 | 01 | CT | WELLCARE | OTHER | 03-70683 | 01 | CT | UHC | OTHER | P00964315 | 01 | CT | RR MEDICARE | OTHER | 001244276 | 05 | CT | MEDICAID | 03-70683 | 01 | CT | AMERICHOICE | OTHER | 010024427CT03 | 01 | CT | ANTHEM BCBS CT | OTHER | 231767 | 01 | CT | USA | OTHER | P2608697 | 01 | CT | OXFORD | OTHER | 2V2114 | 01 | CT | HEALTHNET/COMMERCIAL | OTHER | 024427 | 01 | CT | CONNECTICARE | OTHER | 2769163/4262581 | 01 | CT | AETNA | OTHER |