Provider Demographics
NPI:1437181179
Name:HELLELOID, CHARLES R (MD)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:R
Last Name:HELLELOID
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 1:1918 COUNTY ROAD 138
Mailing Address - Street 2:
Mailing Address - City:INTERNATIONAL FALLS
Mailing Address - State:MN
Mailing Address - Zip Code:56649-8752
Mailing Address - Country:US
Mailing Address - Phone:218-286-5249
Mailing Address - Fax:
Practice Address - Street 1:13071 NETT LAKE RD
Practice Address - Street 2:
Practice Address - City:ORR
Practice Address - State:MN
Practice Address - Zip Code:55771-8111
Practice Address - Country:US
Practice Address - Phone:218-757-3650
Practice Address - Fax:218-757-0234
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2008-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN22164207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN460L8HEOtherBCBS
MNP00337427Medicare PIN
MN460L8HEOtherBCBS