Provider Demographics
NPI:1821044926
Name:VOLK, CHARLES R (MD)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:R
Last Name:VOLK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:200 S 5TH ST
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58504-5675
Mailing Address - Country:US
Mailing Address - Phone:701-222-3937
Mailing Address - Fax:701-222-8805
Practice Address - Street 1:200 S 5TH ST
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58504-5675
Practice Address - Country:US
Practice Address - Phone:701-222-3937
Practice Address - Fax:701-222-8805
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2020-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND4551207W00000X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND1453554Medicaid
180011688OtherRAILROAD MEDICARE ID
ND24737OtherBCBS - NORTH CLINIC
08-01422OtherMEDICA - NORTH CLINIC
21447OtherSIOUX VALLEY HEALTH PLAN
ND280OtherBCBS - MAIN CLINIC
488241044237OtherPREFERRED ONE
08-01423OtherMEDICA - MAIN CLINIC
SD7771140Medicaid
ND13886Medicaid
MT484263Medicaid
180011688OtherRAILROAD MEDICARE ID
ND13886Medicaid