Provider Demographics
NPI:1568859247
Name:CHARLES A SHALLER MD PLLC
Entity Type:Organization
Organization Name:CHARLES A SHALLER MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:A
Authorized Official - Last Name:SHALLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:828-421-0112
Mailing Address - Street 1:36 WESTGATE PLZ
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:NC
Mailing Address - Zip Code:28734-1422
Mailing Address - Country:US
Mailing Address - Phone:828-369-4236
Mailing Address - Fax:828-369-0753
Practice Address - Street 1:36 WESTGATE PLZ
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:NC
Practice Address - Zip Code:28734-1422
Practice Address - Country:US
Practice Address - Phone:828-369-4236
Practice Address - Fax:828-369-0753
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-21
Last Update Date:2015-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9400350207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty