Provider Demographics
NPI:1801837653
Name:CHEEK, DEANNA ELLINGTON (MD)
Entity Type:Individual
Prefix:MRS
First Name:DEANNA
Middle Name:ELLINGTON
Last Name:CHEEK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:DEANNA
Other - Middle Name:ELLINGTON
Other - Last Name:CHEEK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:2093 HENRY TECKLENBURG DR
Mailing Address - Street 2:SUITE 307
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29414-5743
Mailing Address - Country:US
Mailing Address - Phone:843-573-0821
Mailing Address - Fax:843-573-0859
Practice Address - Street 1:2093 HENRY TECKLENBURG DR
Practice Address - Street 2:SUITE 307
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29414-5743
Practice Address - Country:US
Practice Address - Phone:843-573-0821
Practice Address - Fax:843-573-0859
Is Sole Proprietor?:No
Enumeration Date:2006-06-10
Last Update Date:2007-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC14170207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC141705Medicaid
SC141705Medicaid
SCB48187Medicare UPIN