Provider Demographics
NPI:1538170402
Name:HO, CHARLES C (MD)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:C
Last Name:HO
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 1:2583 WOODBLUFF LN
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45458-9549
Mailing Address - Country:US
Mailing Address - Phone:937-885-7503
Mailing Address - Fax:
Practice Address - Street 1:2583 WOODBLUFF LN
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45458-9549
Practice Address - Country:US
Practice Address - Phone:937-885-7503
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3268208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation