Provider Demographics
NPI:1972345270
Name:MCWHARTER, CHARLES MARION II
Entity type:Individual
Prefix:
First Name:CHARLES
Middle Name:MARION
Last Name:MCWHARTER
Suffix:II
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 TICK HOLLOW RD UNIT M
Mailing Address - Street 2:
Mailing Address - City:WHEELERSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:45694-9506
Mailing Address - Country:US
Mailing Address - Phone:740-821-0255
Mailing Address - Fax:
Practice Address - Street 1:330 TICK HOLLOW RD UNIT M
Practice Address - Street 2:
Practice Address - City:WHEELERSBURG
Practice Address - State:OH
Practice Address - Zip Code:45694-9506
Practice Address - Country:US
Practice Address - Phone:740-821-0255
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-10
Last Update Date:2024-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant