Provider Demographics
NPI:1790055820
Name:CHARLES H. WAPLES, M.D., P.C.
Entity Type:Organization
Organization Name:CHARLES H. WAPLES, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:H
Authorized Official - Last Name:WAPLES
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:215-747-9195
Mailing Address - Street 1:5801 SPRUCE ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19139-3833
Mailing Address - Country:US
Mailing Address - Phone:215-747-9195
Mailing Address - Fax:215-474-3438
Practice Address - Street 1:5801 SPRUCE ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19139-3833
Practice Address - Country:US
Practice Address - Phone:215-747-9195
Practice Address - Fax:215-474-3438
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-05
Last Update Date:2012-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD021105-E207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty