Provider Demographics
NPI:1346255148
Name:VANCE, CHARLES RAINEY (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:RAINEY
Last Name:VANCE
Suffix:
Gender:M
Credentials:MD, PHD
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Mailing Address - Street 1:300 VEAZEY DR
Mailing Address - Street 2:CENTRAL REGIONAL HOSPITAL FORENSIC SERVICES UNIT
Mailing Address - City:BUTNER
Mailing Address - State:NC
Mailing Address - Zip Code:27509-1668
Mailing Address - Country:US
Mailing Address - Phone:919-764-5212
Mailing Address - Fax:919-764-5297
Practice Address - Street 1:300 VEAZEY DR
Practice Address - Street 2:CENTRAL REGIONAL HOSPITAL FORENSIC SERVICES UNIT
Practice Address - City:BUTNER
Practice Address - State:NC
Practice Address - Zip Code:27509-1668
Practice Address - Country:US
Practice Address - Phone:919-764-5212
Practice Address - Fax:919-764-5297
Is Sole Proprietor?:No
Enumeration Date:2006-07-30
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC94013562084F0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084F0202XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyForensic Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCBV5230747OtherDEA NUMBER
NCH41787Medicare UPIN