Provider Demographics
NPI:1437303476
Name:CASWELL, AMBER DAWN (MD)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:DAWN
Last Name:CASWELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:AMBER
Other - Middle Name:DAWN
Other - Last Name:SHAFF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:28 BLUE HERON PT
Mailing Address - Street 2:
Mailing Address - City:HILTON HEAD ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29926-1209
Mailing Address - Country:US
Mailing Address - Phone:843-415-6493
Mailing Address - Fax:
Practice Address - Street 1:845 WILLIAM HILTON PKWY
Practice Address - Street 2:
Practice Address - City:HILTON HEAD ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29928-3404
Practice Address - Country:US
Practice Address - Phone:843-341-2416
Practice Address - Fax:843-341-2417
Is Sole Proprietor?:No
Enumeration Date:2008-11-04
Last Update Date:2012-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC32529207Q00000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2073949OtherMEDICARE PTAN