Provider Demographics
NPI:1679557169
Name:BUSWELL CHARKOW, DON R (MD)
Entity Type:Individual
Prefix:DR
First Name:DON
Middle Name:R
Last Name:BUSWELL CHARKOW
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:11140 W COLONIAL DR STE 1
Mailing Address - Street 2:
Mailing Address - City:OCOEE
Mailing Address - State:FL
Mailing Address - Zip Code:34761-3300
Mailing Address - Country:US
Mailing Address - Phone:407-877-6500
Mailing Address - Fax:321-203-4612
Practice Address - Street 1:11140 W COLONIAL DR STE 1
Practice Address - Street 2:
Practice Address - City:OCOEE
Practice Address - State:FL
Practice Address - Zip Code:34761-3300
Practice Address - Country:US
Practice Address - Phone:407-877-6500
Practice Address - Fax:321-203-4612
Is Sole Proprietor?:No
Enumeration Date:2005-11-30
Last Update Date:2020-05-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME38115207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL79601XOtherBCBS OF FLORIDA
FL2221373OtherAETNA HMO
FL4071771OtherAETNA PPO
FL79601XMedicare PIN
FL79601XOtherBCBS OF FLORIDA
FL4071771OtherAETNA PPO