Provider Demographics
NPI:1891743696
Name:MARCHMAN, CHARLES W (MD)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:W
Last Name:MARCHMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 10005
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:AL
Mailing Address - Zip Code:35631-2005
Mailing Address - Country:US
Mailing Address - Phone:256-335-1643
Mailing Address - Fax:
Practice Address - Street 1:2111 CLOYD BLVD
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:AL
Practice Address - Zip Code:35630-1503
Practice Address - Country:US
Practice Address - Phone:256-768-8600
Practice Address - Fax:256-768-8606
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-04
Last Update Date:2018-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL18100208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
51511855Medicare ID - Type Unspecified
E39833Medicare UPIN