Provider Demographics
NPI:1629795430
Name:HOGUE, CHARLES COWAN II
Entity Type:Individual
Prefix:MR
First Name:CHARLES
Middle Name:COWAN
Last Name:HOGUE
Suffix:II
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:CHARLES
Other - Middle Name:COWAN
Other - Last Name:HOGUE
Other - Suffix:II
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1073
Mailing Address - Street 2:
Mailing Address - City:BELMONT
Mailing Address - State:NC
Mailing Address - Zip Code:28012-1073
Mailing Address - Country:US
Mailing Address - Phone:704-349-6111
Mailing Address - Fax:
Practice Address - Street 1:2014 CASTLETON CT APT F
Practice Address - Street 2:
Practice Address - City:BELMONT
Practice Address - State:NC
Practice Address - Zip Code:28012-2292
Practice Address - Country:US
Practice Address - Phone:704-349-6111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-24
Last Update Date:2022-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program