Provider Demographics
NPI:1558391516
Name:STURGES, CHARLES EDWARD (MD)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:EDWARD
Last Name:STURGES
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 1:175 WATER ST
Mailing Address - Street 2:
Mailing Address - City:CATSKILL
Mailing Address - State:NY
Mailing Address - Zip Code:12414-1600
Mailing Address - Country:US
Mailing Address - Phone:518-943-6520
Mailing Address - Fax:518-943-7038
Practice Address - Street 1:175 WATER ST
Practice Address - Street 2:
Practice Address - City:CATSKILL
Practice Address - State:NY
Practice Address - Zip Code:12414-1600
Practice Address - Country:US
Practice Address - Phone:518-943-6520
Practice Address - Fax:518-943-7038
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-04
Last Update Date:2008-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY132486207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY78A871Medicare PIN
NYB19326Medicare UPIN