Provider Demographics
NPI:1003892886
Name:BETTS, CHARLES S (MD)
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:S
Last Name:BETTS
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 1:1831 N FAYETTEVILLE ST
Mailing Address - Street 2:
Mailing Address - City:ASHEBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27203-3273
Mailing Address - Country:US
Mailing Address - Phone:336-672-1300
Mailing Address - Fax:336-672-3044
Practice Address - Street 1:1831 N FAYETTEVILLE ST
Practice Address - Street 2:
Practice Address - City:ASHEBORO
Practice Address - State:NC
Practice Address - Zip Code:27203-3273
Practice Address - Country:US
Practice Address - Phone:336-672-1300
Practice Address - Fax:336-672-3044
Is Sole Proprietor?:No
Enumeration Date:2005-12-22
Last Update Date:2020-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC18490207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC15409OtherBCBS
NC8915409Medicaid
C80699Medicare UPIN
NC15409OtherBCBS