Provider Demographics
NPI:1417938606
Name:GINSBURGH, CHARLES L (MD)
Entity type:Individual
Prefix:
First Name:CHARLES
Middle Name:L
Last Name:GINSBURGH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:860 OMNI BLVD
Mailing Address - Street 2:SUITE 303
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606-4430
Mailing Address - Country:US
Mailing Address - Phone:757-232-8777
Mailing Address - Fax:757-232-8866
Practice Address - Street 1:704 THIMBLE SHOALS BLVD
Practice Address - Street 2:BLDG 5
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-4544
Practice Address - Country:US
Practice Address - Phone:757-599-1066
Practice Address - Fax:757-594-1342
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-07
Last Update Date:2011-09-07
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Provider Licenses
StateLicense IDTaxonomies
VA0101036929207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA080166913OtherRAILROAD MEDICARE
VA5615119Medicaid
VA080166913OtherRAILROAD MEDICARE
VAE59981Medicare UPIN