Provider Demographics
NPI:1699715011
Name:HILES, CHARLES H JR (MD)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:H
Last Name:HILES
Suffix:JR
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 1:240 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WOLFEBORO
Mailing Address - State:NH
Mailing Address - Zip Code:03894-4411
Mailing Address - Country:US
Mailing Address - Phone:603-569-7588
Mailing Address - Fax:603-569-7589
Practice Address - Street 1:240 S MAIN ST STE J
Practice Address - Street 2:INTERNAL MEDICINE ASSOCIATES OF WOLFEBORO
Practice Address - City:WOLFEBORO
Practice Address - State:NH
Practice Address - Zip Code:03894-4411
Practice Address - Country:US
Practice Address - Phone:603-569-7588
Practice Address - Fax:603-569-7589
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2021-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV22885207R00000X
NH16224207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA005833752Medicaid
WV000475699OtherBLUE CROSS BLUE SHIELD
VA284099OtherANTHEM
VA4275813OtherAETNA
VA1699715011Medicaid
WV3810011077Medicaid
VA9693005OtherCIGNA
VA293581OtherSOUTHERN HEALTH
VA284099OtherANTHEM
VA1699715011Medicaid
VA005833752Medicaid
010397P45Medicare ID - Type Unspecified
VA110191335Medicare PIN