Provider Demographics
NPI:1851378491
Name:RATHKE, CHARLES ERNEST (MD)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:ERNEST
Last Name:RATHKE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:216 MILL STREAM WAY
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23185-3187
Mailing Address - Country:US
Mailing Address - Phone:757-229-9394
Mailing Address - Fax:757-229-9394
Practice Address - Street 1:1550 TOMCAT BLVD
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23460-2218
Practice Address - Country:US
Practice Address - Phone:757-314-7128
Practice Address - Fax:757-436-6843
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-25
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101019524208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics