Provider Demographics
NPI:1134141559
Name:HEMENWAY, CHARLES GERAKD II (MD)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:GERAKD
Last Name:HEMENWAY
Suffix:II
Gender:M
Credentials:MD
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Mailing Address - Street 1:111 BEACH RD
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06824-6668
Mailing Address - Country:US
Mailing Address - Phone:203-256-9249
Mailing Address - Fax:203-256-0760
Practice Address - Street 1:111 BEACH RD
Practice Address - Street 2:3RD FLOOR
Practice Address - City:FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06824-6668
Practice Address - Country:US
Practice Address - Phone:203-256-9249
Practice Address - Fax:203-256-0760
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-24
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
CT0163452080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine