Provider Demographics
NPI:1295733244
Name:WILKES, CHARLES A (MD)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:A
Last Name:WILKES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:844 KEMPSVILLE RD
Mailing Address - Street 2:STE 208
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23502-3927
Mailing Address - Country:US
Mailing Address - Phone:757-461-3890
Mailing Address - Fax:757-461-0836
Practice Address - Street 1:844 KEMPSVILLE RD
Practice Address - Street 2:STE 208
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23502-3927
Practice Address - Country:US
Practice Address - Phone:757-461-3890
Practice Address - Fax:757-461-0836
Is Sole Proprietor?:No
Enumeration Date:2005-07-13
Last Update Date:2011-12-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101033142207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA6208266Medicaid
VA160001340Medicare ID - Type Unspecified
VA6208266Medicaid