Provider Demographics
NPI:1619930120
Name:TITONE, CHARLES WILLIAM (MD)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:WILLIAM
Last Name:TITONE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1011 WH SMITH BLVD
Mailing Address - Street 2:SUITE 108
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-5052
Mailing Address - Country:US
Mailing Address - Phone:252-355-7301
Mailing Address - Fax:252-364-3140
Practice Address - Street 1:1011 WH SMITH BLVD
Practice Address - Street 2:SUITE 108
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-5052
Practice Address - Country:US
Practice Address - Phone:252-355-7301
Practice Address - Fax:252-364-3140
Is Sole Proprietor?:No
Enumeration Date:2006-04-07
Last Update Date:2020-09-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC200300097207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89133W8Medicaid
NC133W8OtherBCBS PROV #
NC89133W8Medicaid
NC133W8OtherBCBS PROV #
D82336Medicare UPIN
NC2014870DMedicare PIN
NC2014870AMedicare PIN