Provider Demographics
NPI:1699823443
Name:DU CHARME, ROBERT CHARLES JR (PA-C)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:CHARLES
Last Name:DU CHARME
Suffix:JR
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:BOB
Other - Middle Name:
Other - Last Name:DU CHARME
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:BS, MPAS
Mailing Address - Street 1:128 HAZELWOOD DR
Mailing Address - Street 2:
Mailing Address - City:FOREST CITY
Mailing Address - State:NC
Mailing Address - Zip Code:28043-6143
Mailing Address - Country:US
Mailing Address - Phone:828-748-0402
Mailing Address - Fax:
Practice Address - Street 1:461 WESTERN BLVD STE 122
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28546-7637
Practice Address - Country:US
Practice Address - Phone:910-333-2335
Practice Address - Fax:910-333-0283
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC102346363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC102346OtherNC
NC8101247Medicaid
NC8101247Medicaid
NC102346OtherNC
MD 0279198OtherDEA