Provider Demographics
NPI:1528008463
Name:CHARLES, ROBERT S (MD)
Entity Type:Individual
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First Name:ROBERT
Middle Name:S
Last Name:CHARLES
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Gender:M
Credentials:MD
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Mailing Address - Street 1:140 W GERMANTOWN PIKE
Mailing Address - Street 2:STE 250
Mailing Address - City:PLYMOUTH MEETING
Mailing Address - State:PA
Mailing Address - Zip Code:19462-1421
Mailing Address - Country:US
Mailing Address - Phone:484-530-0205
Mailing Address - Fax:484-530-0209
Practice Address - Street 1:1235 OLD YORK RD
Practice Address - Street 2:SUITE 210
Practice Address - City:ABINGTON
Practice Address - State:PA
Practice Address - Zip Code:19001
Practice Address - Country:US
Practice Address - Phone:215-517-1100
Practice Address - Fax:215-517-1130
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2019-10-02
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Provider Licenses
StateLicense IDTaxonomies
PAMD025203E208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAO10J854ZMedicaid
PA193235U0AMedicare ID - Type Unspecified
C33207Medicare UPIN