Provider Demographics
NPI:1346268323
Name:FERREE, CHARLES ELLIOT (MD)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:ELLIOT
Last Name:FERREE
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 1:5960 FAIRVIEW RD STE 500
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28210-3113
Mailing Address - Country:US
Mailing Address - Phone:704-495-6334
Mailing Address - Fax:704-817-7219
Practice Address - Street 1:10635 PARK RD STE I
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28210-8408
Practice Address - Country:US
Practice Address - Phone:704-495-6025
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC27175207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1346268323Medicaid
NC8931721Medicaid
SCN27175Medicaid
NC31721OtherBC BS NC
NC110229720OtherRR MEDICARE
NC206259KMedicare PIN
NC31721OtherBC BS NC
NC8931721Medicaid
NC206259CMedicare PIN
NC206259HMedicare PIN
NC1346268323Medicaid