Provider Demographics
NPI:1568466951
Name:SPINGOLA, CHARLES EDWARD (MD)
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:EDWARD
Last Name:SPINGOLA
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 1:131 GROSVENOR AVE
Mailing Address - Street 2:
Mailing Address - City:BUTLER
Mailing Address - State:PA
Mailing Address - Zip Code:16001-1618
Mailing Address - Country:US
Mailing Address - Phone:724-679-8527
Mailing Address - Fax:724-278-8549
Practice Address - Street 1:131 GROSVENOR AVE
Practice Address - Street 2:
Practice Address - City:BUTLER
Practice Address - State:PA
Practice Address - Zip Code:16001-1618
Practice Address - Country:US
Practice Address - Phone:724-679-8527
Practice Address - Fax:724-278-8549
Is Sole Proprietor?:No
Enumeration Date:2005-06-13
Last Update Date:2023-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD 037925 E207X00000X
NHLT4098207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0010833110001Medicaid
PA95310SLVMedicare PIN
PA0010833110001Medicaid