Provider Demographics
NPI:1114109188
Name:SUBER, CHARLES E (DC)
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:E
Last Name:SUBER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:317 SANFORD DR
Mailing Address - Street 2:
Mailing Address - City:MORGANTON
Mailing Address - State:NC
Mailing Address - Zip Code:28655-2573
Mailing Address - Country:US
Mailing Address - Phone:828-433-7611
Mailing Address - Fax:828-433-7616
Practice Address - Street 1:317 SANFORD DR
Practice Address - Street 2:
Practice Address - City:MORGANTON
Practice Address - State:NC
Practice Address - Zip Code:28655-2573
Practice Address - Country:US
Practice Address - Phone:828-433-7611
Practice Address - Fax:828-433-7616
Is Sole Proprietor?:No
Enumeration Date:2007-12-03
Last Update Date:2007-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2859111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC085ACOtherBCBS
NC89085ACMedicaid
NC89085ACMedicaid