Provider Demographics
NPI:1023011962
Name:SCHLEUPNER, CHARLES JOHN (MD)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:JOHN
Last Name:SCHLEUPNER
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 1:1970 ROANOKE BOULEVARD
Mailing Address - Street 2:DEPARTMENT OF VETERANS AFFAIRS MEDICAL CENTER
Mailing Address - City:SALEM
Mailing Address - State:VA
Mailing Address - Zip Code:24153
Mailing Address - Country:US
Mailing Address - Phone:540-982-2463
Mailing Address - Fax:540-855-3406
Practice Address - Street 1:1970 ROANOKE BOULEVARD
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:VA
Practice Address - Zip Code:24153
Practice Address - Country:US
Practice Address - Phone:540-982-2463
Practice Address - Fax:540-855-3406
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-24
Last Update Date:2021-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC98-01050207RI0200X
VA0101-029045207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA110002562Medicare PIN
NCB60221Medicare UPIN