1750513503 NPI number — MR. CHARLES H BARTON

Table of content: MR. CHARLES H BARTON (NPI 1750513503)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1750513503 NPI number — MR. CHARLES H BARTON

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BARTON
Provider First Name:
CHARLES
Provider Middle Name:
H
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BARTON
Provider Other First Name:
CHARLES
Provider Other Middle Name:
H
Provider Other Name Prefix Text:
MR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
CRNA
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1750513503
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/12/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 159
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BAKERTON
Provider Business Mailing Address State Name:
WV
Provider Business Mailing Address Postal Code:
25410-0159
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
304-876-1453
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
110 BAUGHMANS LN
Provider Second Line Business Practice Location Address:
SUITE 201
Provider Business Practice Location Address City Name:
FREDERICK
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21702-4059
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
304-876-1453
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/12/2009

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 367500000X , with the licence number:  R171823 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)