Provider Demographics
NPI:1174503692
Name:PADOS, CHARLES F (DC)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:F
Last Name:PADOS
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 1:3308 STATE ST
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16508-2830
Mailing Address - Country:US
Mailing Address - Phone:814-453-3150
Mailing Address - Fax:814-453-3150
Practice Address - Street 1:3308 STATE ST
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16508-2858
Practice Address - Country:US
Practice Address - Phone:814-453-3150
Practice Address - Fax:814-453-3150
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-19
Last Update Date:2017-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC004603L111NX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0100XChiropractic ProvidersChiropractorOccupational Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0012621070001Medicaid
PA7810095OtherAETNA
PA1502531OtherGATEWAY
PA216178OtherUPMC
PA415781OtherHEALTH AMERICA
PA698747OtherHIGHMARK BCBS
PA994720OtherHIGHMARK BCBS
PA216178OtherUPMC
PA415781OtherHEALTH AMERICA