Provider Demographics
NPI:1740362672
Name:NAUMANN, CHARLES ERIC (DC)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:ERIC
Last Name:NAUMANN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 LOGAN ST
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:NY
Mailing Address - Zip Code:13021-3908
Mailing Address - Country:US
Mailing Address - Phone:315-253-7961
Mailing Address - Fax:315-253-7961
Practice Address - Street 1:1 LOGAN ST
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:NY
Practice Address - Zip Code:13021-3908
Practice Address - Country:US
Practice Address - Phone:315-253-7961
Practice Address - Fax:315-253-7961
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0049721111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0049721OtherCHIROPRACTIC LICENSE
NYX0049728OtherWORKERS COMP AUTH
50621BMedicare ID - Type Unspecified