Provider Demographics
NPI:1083892343
Name:CHARLES E.M. CAMPBELL, MD
Entity Type:Organization
Organization Name:CHARLES E.M. CAMPBELL, MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:E
Authorized Official - Last Name:CAMPBELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:215-538-3888
Mailing Address - Street 1:127 S 5TH ST
Mailing Address - Street 2:THE ATRIUM SUITE 200
Mailing Address - City:QUAKERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18951-1680
Mailing Address - Country:US
Mailing Address - Phone:215-538-3888
Mailing Address - Fax:215-538-3892
Practice Address - Street 1:127 S 5TH ST
Practice Address - Street 2:THE ATRIUM SUITE 200
Practice Address - City:QUAKERTOWN
Practice Address - State:PA
Practice Address - Zip Code:18951-1682
Practice Address - Country:US
Practice Address - Phone:215-538-3888
Practice Address - Fax:215-538-3892
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-08
Last Update Date:2008-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD-015132E332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000890487-0003Medicaid
PA000890487-0003Medicaid
PA161885Medicare PIN