Provider Demographics
NPI:1295822062
Name:CAMPBELL, CHARLES E M (MD)
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:E M
Last Name:CAMPBELL
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 1:127 SOUTH 5TH STREET
Mailing Address - Street 2:THE ATRIUM SUITE 200
Mailing Address - City:QUAKERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18951
Mailing Address - Country:US
Mailing Address - Phone:215-538-3888
Mailing Address - Fax:215-538-3892
Practice Address - Street 1:127 SOUTH 5TH STREET
Practice Address - Street 2:THE ATRIUM SUITE 200
Practice Address - City:QUAKERTOWN
Practice Address - State:PA
Practice Address - Zip Code:18951
Practice Address - Country:US
Practice Address - Phone:215-538-3888
Practice Address - Fax:215-538-3892
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD-015132E207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
161885Medicare ID - Type Unspecified
0738310001Medicare NSC
C32423Medicare UPIN