Provider Demographics
NPI:1225697451
Name:DURHAM, CHARITY (DO)
Entity type:Individual
Prefix:DR
First Name:CHARITY
Middle Name:
Last Name:DURHAM
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:CHARITY
Other - Middle Name:
Other - Last Name:ORRISS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:282 W MAIN ST STE 203
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:CT
Mailing Address - Zip Code:06001-3639
Mailing Address - Country:US
Mailing Address - Phone:860-901-2249
Mailing Address - Fax:860-271-0998
Practice Address - Street 1:282 W MAIN ST STE 203
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:CT
Practice Address - Zip Code:06001-3639
Practice Address - Country:US
Practice Address - Phone:860-901-2249
Practice Address - Fax:860-271-0998
Is Sole Proprietor?:No
Enumeration Date:2019-06-11
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY153-T2207Q00000X
CT70567207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine