Provider Demographics
NPI:1316918675
Name:BOXMAN, CHARLES (DPM)
Entity type:Individual
Prefix:
First Name:CHARLES
Middle Name:
Last Name:BOXMAN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:392 N WHITE HORSE PIKE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:HAMMONTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08037-1866
Mailing Address - Country:US
Mailing Address - Phone:609-704-9001
Mailing Address - Fax:609-704-8316
Practice Address - Street 1:392 N WHITE HORSE PIKE
Practice Address - Street 2:SUITE 2
Practice Address - City:HAMMONTON
Practice Address - State:NJ
Practice Address - Zip Code:08037-1866
Practice Address - Country:US
Practice Address - Phone:609-704-9001
Practice Address - Fax:609-704-8316
Is Sole Proprietor?:No
Enumeration Date:2006-01-26
Last Update Date:2014-05-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJMD00960213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ760230000OtherLOCAL 54
NJ008886100OtherAMERIHEALTH
NJ145908OtherUNITED HEALTHCARE
NJP2690395OtherOXFORD
NJ9713328OtherGHI
NJ1730703Medicaid
NJ760230000OtherLOCAL 54
NJ480927010Medicare PIN
NJ$$$$$$$$$OtherBLUE CROSS BLUE SHIELD
NJ$$$$$$$$$Medicare PIN
NJ9713328OtherGHI
NJ4172620001Medicare NSC