Provider Demographics
NPI:1528013109
Name:SEEHORN, CHARLES (MD)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:
Last Name:SEEHORN
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 RANDOLPH RD STE 600
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28207-1198
Mailing Address - Country:US
Mailing Address - Phone:704-342-0252
Mailing Address - Fax:980-533-7801
Practice Address - Street 1:1918 RANDOLPH RD
Practice Address - Street 2:STE 600
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28207-1100
Practice Address - Country:US
Practice Address - Phone:704-342-0252
Practice Address - Fax:704-342-1853
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2022-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200200797207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8631095001OtherCIGNA
NCC0577OtherMEDCOST
NC660003874OtherRAILROAD MEDICARE
NC89132PEMedicaid
NC132PEOtherBCBS
NC181712OtherCOVENTRY
NC7999341OtherAETNA- NON-HMO
NC257031OtherMAMSI
NC2828844OtherAETNA-HMO
NC800404OtherPARTNERS
NC2006354Medicare ID - Type Unspecified
NC89132PEMedicaid