Provider Demographics
NPI:1427055714
Name:FELIX, CHARLES GEORGE (MD)
Entity type:Individual
Prefix:
First Name:CHARLES
Middle Name:GEORGE
Last Name:FELIX
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2939 W COURSE RD
Mailing Address - Street 2:
Mailing Address - City:MAUMEE
Mailing Address - State:OH
Mailing Address - Zip Code:43537-9629
Mailing Address - Country:US
Mailing Address - Phone:419-865-0506
Mailing Address - Fax:419-740-5918
Practice Address - Street 1:2939 W COURSE RD
Practice Address - Street 2:
Practice Address - City:MAUMEE
Practice Address - State:OH
Practice Address - Zip Code:43537-9629
Practice Address - Country:US
Practice Address - Phone:419-865-0506
Practice Address - Fax:419-740-5918
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-01
Last Update Date:2020-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.082833146D00000X
OH35082833F207Q00000X
CAC167574207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No146D00000XEmergency Medical Service ProvidersPersonal Emergency Response Attendant
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2426575Medicaid
OHH93177Medicare UPIN
OHFE4150643Medicare ID - Type Unspecified
MIP29800001Medicare PIN