Provider Demographics
NPI:1336140599
Name:GIVENS, CHARLES T (MD,)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:T
Last Name:GIVENS
Suffix:
Gender:M
Credentials:MD,
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Mailing Address - Street 1:4885 DEMOSS RD
Mailing Address - Street 2:SUITE201
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19606-9023
Mailing Address - Country:US
Mailing Address - Phone:610-779-9489
Mailing Address - Fax:610-779-9487
Practice Address - Street 1:4885 DE MOSS RD
Practice Address - Street 2:SUITE 201
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19606-0309
Practice Address - Country:US
Practice Address - Phone:610-779-9489
Practice Address - Fax:610-779-9487
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2016-09-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD067615L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001818522Medicaid
PA028266Medicare PIN
PAG87112Medicare UPIN