Provider Demographics
NPI:1326100884
Name:DYE, CHARLES EDWARD (MD)
Entity Type:Individual
Prefix:MR
First Name:CHARLES
Middle Name:EDWARD
Last Name:DYE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:500 UNIVERSITY AVE
Mailing Address - Street 2:SUITE 4100
Mailing Address - City:HERSEY
Mailing Address - State:PA
Mailing Address - Zip Code:17033
Mailing Address - Country:US
Mailing Address - Phone:717-531-3834
Mailing Address - Fax:717-531-4598
Practice Address - Street 1:500 UNIVERSITY AVE
Practice Address - Street 2:SUITE 4100
Practice Address - City:HERSHEY
Practice Address - State:PA
Practice Address - Zip Code:17033
Practice Address - Country:US
Practice Address - Phone:717-531-3834
Practice Address - Fax:717-531-4598
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2015-02-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036097290207RG0100X
PAMD435401207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036097290Medicaid
IL036097290Medicaid