Provider Demographics
NPI:1699849505
Name:MEUSBURGER, CHARLES E (MD)
Entity type:Individual
Prefix:
First Name:CHARLES
Middle Name:E
Last Name:MEUSBURGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3069 ENGLISH CREEK AVE
Mailing Address - Street 2:SUITE 225
Mailing Address - City:EGG HARBOR TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:08234-9708
Mailing Address - Country:US
Mailing Address - Phone:609-484-0770
Mailing Address - Fax:609-484-0701
Practice Address - Street 1:3069 ENGLISH CREEK AVE
Practice Address - Street 2:SUITE 225
Practice Address - City:EGG HARBOR TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:08234-9708
Practice Address - Country:US
Practice Address - Phone:609-484-0770
Practice Address - Fax:609-484-0701
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2016-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MAO54919002084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJE53474Medicare UPIN
NJ108765Medicare PIN