Provider Demographics
NPI:1396739983
Name:HAWS, CHARLES W (MD)
Entity type:Individual
Prefix:
First Name:CHARLES
Middle Name:W
Last Name:HAWS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3725 W 4100 S
Mailing Address - Street 2:SUITE 201
Mailing Address - City:WEST VALLEY CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84120-5530
Mailing Address - Country:US
Mailing Address - Phone:801-676-3776
Mailing Address - Fax:801-676-0987
Practice Address - Street 1:3725 W 4100 S
Practice Address - Street 2:SUITE 201
Practice Address - City:WEST VALLEY CITY
Practice Address - State:UT
Practice Address - Zip Code:84120-5530
Practice Address - Country:US
Practice Address - Phone:801-676-3776
Practice Address - Fax:801-676-0987
Is Sole Proprietor?:No
Enumeration Date:2005-09-09
Last Update Date:2012-10-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
UT1712991205207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
A02215Medicare UPIN
UTU000075621Medicare PIN