Provider Demographics
NPI:1235225160
Name:BILLINGTON, CHARLES JOHN (MD)
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:JOHN
Last Name:BILLINGTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:UNIVERSITY OF MINNESOTA PHYSICIANS
Mailing Address - Street 2:420 DELAWARE ST SE MMC 101
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55455
Mailing Address - Country:US
Mailing Address - Phone:612-725-2000
Mailing Address - Fax:
Practice Address - Street 1:MINNEAPOLIS VAMC, METABOLIC SECTION (111G)
Practice Address - Street 2:ONE VETERANS DRIVE
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55417
Practice Address - Country:US
Practice Address - Phone:612-725-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN25965207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN33-00009OtherMEDICA-PRIMARY
MN1043323OtherPREFERRED ONE
MN582803100Medicaid
B575OtherCHAMPUS
9357615OtherPHCS
MN132686OtherU CARE
MN33--00167OtherMEDICA-CHOICE
HP49943OtherHEALTH PARTNERS
MN2274316OtherARAZID
P00307732OtherRR MEDICARE
MN33-00009OtherMEDICA-PRIMARY
HP49943OtherHEALTH PARTNERS
MNI21233Medicare UPIN