Provider Demographics
NPI:1750848693
Name:CASKEY, HERBERT TARTER (MD)
Entity Type:Individual
Prefix:
First Name:HERBERT
Middle Name:TARTER
Last Name:CASKEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 E CITY AVE STE 820
Mailing Address - Street 2:
Mailing Address - City:BALA CYNWYD
Mailing Address - State:PA
Mailing Address - Zip Code:19004-1130
Mailing Address - Country:US
Mailing Address - Phone:610-668-8800
Mailing Address - Fax:610-667-5627
Practice Address - Street 1:401 E CITY AVE STE 820
Practice Address - Street 2:
Practice Address - City:BALA CYNWYD
Practice Address - State:PA
Practice Address - Zip Code:19004-1130
Practice Address - Country:US
Practice Address - Phone:610-668-8800
Practice Address - Fax:610-667-5627
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-27
Last Update Date:2019-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD015115E207R00000X
PAMD0015115E207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine