Provider Demographics
NPI:1730174723
Name:HURWITZ, CHARLES (DO)
Entity type:Individual
Prefix:
First Name:CHARLES
Middle Name:
Last Name:HURWITZ
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:607 E MANOA RD
Mailing Address - Street 2:
Mailing Address - City:HAVERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19083-5602
Mailing Address - Country:US
Mailing Address - Phone:610-213-3716
Mailing Address - Fax:
Practice Address - Street 1:607 E MANOA RD
Practice Address - Street 2:
Practice Address - City:HAVERTOWN
Practice Address - State:PA
Practice Address - Zip Code:19083-5602
Practice Address - Country:US
Practice Address - Phone:610-213-3716
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-15
Last Update Date:2025-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS002981L207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA100015342OtherTRAVELERS MEDICARE
PA0046027000OtherKEYSTONE
PA2381887OtherAETNA
PA32647OtherKEYSTONE MERCY
PA016693OtherBLUE SHIELD
PA2381887OtherAETNA