Provider Demographics
NPI:1962614826
Name:EBERLE, CHARLES F (MD)
Entity type:Individual
Prefix:
First Name:CHARLES
Middle Name:F
Last Name:EBERLE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:6501 MEOQUI CT. NW
Mailing Address - Street 2:
Mailing Address - City:LOS RANCHOS
Mailing Address - State:NM
Mailing Address - Zip Code:87107
Mailing Address - Country:US
Mailing Address - Phone:505-688-5032
Mailing Address - Fax:505-344-1698
Practice Address - Street 1:6501 MEOQUI CT NW
Practice Address - Street 2:
Practice Address - City:LOS RANCHOS
Practice Address - State:NM
Practice Address - Zip Code:87107-5613
Practice Address - Country:US
Practice Address - Phone:505-688-5032
Practice Address - Fax:505-344-1698
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-04
Last Update Date:2015-12-31
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NM82-188207XP3100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XP3100XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryPediatric Orthopaedic Surgery