Provider Demographics
NPI:1346279965
Name:USHER, CHARLES HENDRY (MD)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:HENDRY
Last Name:USHER
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 1:5353 REYNOLDS ST STE 107
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405-6015
Mailing Address - Country:US
Mailing Address - Phone:912-819-7630
Mailing Address - Fax:912-819-5860
Practice Address - Street 1:5353 REYNOLDS ST STE 107
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-6015
Practice Address - Country:US
Practice Address - Phone:912-819-7630
Practice Address - Fax:912-819-5860
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2016-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA035779208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00503555DMedicaid
GA02BDFFGMedicare ID - Type Unspecified
GAF33512Medicare UPIN