Provider Demographics
NPI:1275521353
Name:SOLOMIDES, CHARALAMBOS C (MD)
Entity Type:Individual
Prefix:DR
First Name:CHARALAMBOS
Middle Name:C
Last Name:SOLOMIDES
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 1:132 S 10TH ST
Mailing Address - Street 2:MAIN BUILDING 285K
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-5244
Mailing Address - Country:US
Mailing Address - Phone:215-503-5642
Mailing Address - Fax:215-503-4817
Practice Address - Street 1:132 S 10TH ST
Practice Address - Street 2:MAIN BUILDING 285K
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-5244
Practice Address - Country:US
Practice Address - Phone:215-503-5642
Practice Address - Fax:215-503-4817
Is Sole Proprietor?:No
Enumeration Date:2005-10-12
Last Update Date:2014-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD064072L207ZP0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0105XAllopathic & Osteopathic PhysiciansPathologyClinical Pathology/Laboratory Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7982704Medicaid
PA0017577300001Medicaid
PA0017577300003Medicaid
PA163787PAGMedicare PIN
028447Medicare ID - Type Unspecified
NJ7982704Medicaid