Provider Demographics
NPI:1700866688
Name:NESBITT, CHARLES P (MD)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:P
Last Name:NESBITT
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3100 SPRING FOREST RD
Mailing Address - Street 2:SUITE 130
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27616-2880
Mailing Address - Country:US
Mailing Address - Phone:919-882-0705
Mailing Address - Fax:919-873-9821
Practice Address - Street 1:44045 RIVERSIDE PKWY
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20176-5101
Practice Address - Country:US
Practice Address - Phone:703-858-6000
Practice Address - Fax:571-209-6465
Is Sole Proprietor?:No
Enumeration Date:2006-01-18
Last Update Date:2013-09-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101051771207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1700866688Medicaid
VAVV7221AMedicare UPIN
VAG67124Medicare UPIN
VA1700866688Medicaid