Provider Demographics
NPI:1265469373
Name:BIDDLE, CHARLES M IV (MD)
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:M
Last Name:BIDDLE
Suffix:IV
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:C
Other - Middle Name:MILLER
Other - Last Name:BIDDLE
Other - Suffix:IV
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:701 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MOORESTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08057-3032
Mailing Address - Country:US
Mailing Address - Phone:856-727-9907
Mailing Address - Fax:856-727-9989
Practice Address - Street 1:701 E MAIN ST
Practice Address - Street 2:
Practice Address - City:MOORESTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08057-3032
Practice Address - Country:US
Practice Address - Phone:856-727-9907
Practice Address - Fax:856-727-9989
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-26
Last Update Date:2008-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ052814Medicare PIN
D06872Medicare UPIN