Provider Demographics
NPI:1861461832
Name:CHARLES, WILLIAM M (DO)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:M
Last Name:CHARLES
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9162 W HARBOR ISLE CT
Mailing Address - Street 2:
Mailing Address - City:CRYSTAL RIVER
Mailing Address - State:FL
Mailing Address - Zip Code:34429-8185
Mailing Address - Country:US
Mailing Address - Phone:352-563-5859
Mailing Address - Fax:352-563-5859
Practice Address - Street 1:9162 W HARBOR ISLE CT
Practice Address - Street 2:
Practice Address - City:CRYSTAL RIVER
Practice Address - State:FL
Practice Address - Zip Code:34429-8185
Practice Address - Country:US
Practice Address - Phone:352-563-5859
Practice Address - Fax:352-563-5859
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-14
Last Update Date:2015-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS90372084P0802X, 207L00000X, 2084A0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084A0401XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Medicine
Yes2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Psychiatry
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology