Provider Demographics
NPI:1841262979
Name:KOENIG, CHARLOTTE HERSHBERGER (MD)
Entity type:Individual
Prefix:DR
First Name:CHARLOTTE
Middle Name:HERSHBERGER
Last Name:KOENIG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 2027
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52244-2027
Mailing Address - Country:US
Mailing Address - Phone:319-339-3541
Mailing Address - Fax:319-358-2737
Practice Address - Street 1:819 S HIGHLAND ST
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:IA
Practice Address - Zip Code:52361-9333
Practice Address - Country:US
Practice Address - Phone:319-668-2722
Practice Address - Fax:319-668-2625
Is Sole Proprietor?:No
Enumeration Date:2006-02-02
Last Update Date:2013-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA27499207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
E44374Medicare UPIN