Provider Demographics
NPI:1396887600
Name:PAYNE, CHARLES KIRK (BC-HIS, ACA)
Entity type:Individual
Prefix:MR
First Name:CHARLES
Middle Name:KIRK
Last Name:PAYNE
Suffix:
Gender:M
Credentials:BC-HIS, ACA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8025 RITCHIE HWY
Mailing Address - Street 2:SUITE 102
Mailing Address - City:PASADENA
Mailing Address - State:MD
Mailing Address - Zip Code:21122-1031
Mailing Address - Country:US
Mailing Address - Phone:410-590-5572
Mailing Address - Fax:410-695-3530
Practice Address - Street 1:8025 RITCHIE HWY
Practice Address - Street 2:SUITE 102
Practice Address - City:PASADENA
Practice Address - State:MD
Practice Address - Zip Code:21122-1031
Practice Address - Country:US
Practice Address - Phone:410-590-5572
Practice Address - Fax:443-270-8266
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2011-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD2462237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist