Provider Demographics
NPI:1629000583
Name:HAILE, CHARLES A (MD)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:A
Last Name:HAILE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:7600 OSLER DR
Mailing Address - Street 2:SUITE 411
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-7735
Mailing Address - Country:US
Mailing Address - Phone:410-337-7097
Mailing Address - Fax:410-583-8223
Practice Address - Street 1:7600 OSLER DR
Practice Address - Street 2:SUITE 411
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-7735
Practice Address - Country:US
Practice Address - Phone:410-337-7097
Practice Address - Fax:410-583-8223
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2013-06-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDD17008207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD344741300Medicaid
MD344741300Medicaid
MD667M179FMedicare PIN