Provider Demographics
NPI:1568419943
Name:CHARLES D BESS, MD PC
Entity Type:Organization
Organization Name:CHARLES D BESS, MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:D
Authorized Official - Last Name:BESS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:304-788-6462
Mailing Address - Street 1:PO BOX 944
Mailing Address - Street 2:
Mailing Address - City:KEYSER
Mailing Address - State:WV
Mailing Address - Zip Code:26726-0944
Mailing Address - Country:US
Mailing Address - Phone:304-788-6462
Mailing Address - Fax:304-788-6555
Practice Address - Street 1:514 NEW CREEK HWY
Practice Address - Street 2:
Practice Address - City:KEYSER
Practice Address - State:WV
Practice Address - Zip Code:26726-9526
Practice Address - Country:US
Practice Address - Phone:304-788-6462
Practice Address - Fax:304-788-6555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-30
Last Update Date:2013-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV17588207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV9316781Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER