Provider Demographics
NPI:1659414183
Name:AFEMAN, CHARLES E (MD)
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:E
Last Name:AFEMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:7777 HENNESSY BLVD
Mailing Address - Street 2:SUITE 4000
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70808-4300
Mailing Address - Country:US
Mailing Address - Phone:225-766-7441
Mailing Address - Fax:225-766-7597
Practice Address - Street 1:7777 HENNESSY BLVD
Practice Address - Street 2:SUITE 4000
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70808-4300
Practice Address - Country:US
Practice Address - Phone:225-766-7441
Practice Address - Fax:225-766-7597
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LA008695207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1068314Medicaid
LA180015624OtherRAILROAD MEDICARE
LAB62713Medicare UPIN
LA0328120001Medicare NSC
LA1068314Medicaid