Provider Demographics
NPI:1750497459
Name:SEE, CHARMAINE D (MD)
Entity Type:Individual
Prefix:DR
First Name:CHARMAINE
Middle Name:D
Last Name:SEE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3551 ROGER BROOKE DR
Mailing Address - Street 2:
Mailing Address - City:FORT SAM HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:78234-4504
Mailing Address - Country:US
Mailing Address - Phone:210-539-9582
Mailing Address - Fax:
Practice Address - Street 1:3551 ROGER BROOKE DR
Practice Address - Street 2:
Practice Address - City:FORT SAM HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:78234-4504
Practice Address - Country:US
Practice Address - Phone:210-916-3000
Practice Address - Fax:210-539-2075
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2020-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-098719207Q00000X
TXS2168207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL04932056OtherBLUE CROSS BLUE SHIELD
IL81-0554589OtherFEIN NUMBER
IL137996OtherAETNA
IL04932056OtherBLUE CROSS BLUE SHIELD