Provider Demographics
NPI:1124014634
Name:BETTS, CHARLES R (MD)
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:R
Last Name:BETTS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1 NOLTE DR
Mailing Address - Street 2:P.O. BOX 1001
Mailing Address - City:KITTANNING
Mailing Address - State:PA
Mailing Address - Zip Code:16201-7111
Mailing Address - Country:US
Mailing Address - Phone:724-548-1395
Mailing Address - Fax:724-548-1396
Practice Address - Street 1:1 NOLTE DR
Practice Address - Street 2:SUITE 150
Practice Address - City:KITTANNING
Practice Address - State:PA
Practice Address - Zip Code:16201-7111
Practice Address - Country:US
Practice Address - Phone:724-548-1395
Practice Address - Fax:412-548-1396
Is Sole Proprietor?:No
Enumeration Date:2005-09-21
Last Update Date:2023-04-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD-045564-E207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001409737006Medicaid
PAE61669Medicare UPIN
PA600928Q2YMedicare ID - Type Unspecified