Provider Demographics
NPI:1063440527
Name:GETZ, CHARLES LONNIE (MD)
Entity type:Individual
Prefix:
First Name:CHARLES
Middle Name:LONNIE
Last Name:GETZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:833 CHESTNUT ST STE 520
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-4430
Mailing Address - Country:US
Mailing Address - Phone:800-321-9999
Mailing Address - Fax:267-339-3761
Practice Address - Street 1:600 EVERGREEN DR STE 201
Practice Address - Street 2:
Practice Address - City:GLEN MILLS
Practice Address - State:PA
Practice Address - Zip Code:19342-1053
Practice Address - Country:US
Practice Address - Phone:267-339-3558
Practice Address - Fax:267-339-3763
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2022-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07849700207X00000X
NY307588207X00000X
FLME152802207X00000X
PAMD072654L207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
2205831OtherCIGNA
NJ2404764000OtherIBC
3279957OtherAETNA
PA2181382000OtherIBC
H88035Medicare UPIN
PAP00448696Medicare PIN
PA071066GC6Medicare PIN