Provider Demographics
NPI:1841289147
Name:TERNENT, CHARLES ANDREW (MD)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:ANDREW
Last Name:TERNENT
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:9850 NICHOLAS ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68114-2191
Mailing Address - Country:US
Mailing Address - Phone:402-343-1122
Mailing Address - Fax:402-343-1122
Practice Address - Street 1:9850 NICHOLAS ST
Practice Address - Street 2:SUITE 100
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114-2191
Practice Address - Country:US
Practice Address - Phone:402-343-1122
Practice Address - Fax:402-343-1122
Is Sole Proprietor?:No
Enumeration Date:2005-10-19
Last Update Date:2012-03-14
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Provider Licenses
StateLicense IDTaxonomies
NE19884208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47053395014Medicaid
NE267466Medicare PIN
NE47053395014Medicaid