Daniel, Charles Douglas

Daniel, Charles Douglas is an individual health care provider with primary practice located at 1234 Franklin Rd Sw , Roanoke VA 24016-4606. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Urology. Allopathic & Osteopathic Physicians / Urology is his primary health care specialty. Daniel, Charles Douglas can be contacted via phone (540) 345-1561.

Contact Information

Primary practice address
1234 Franklin Rd Sw Roanoke VA 24016-4606
Phone: (540) 345-1561
Fax: (540) 345-2112
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 0101236633 Virginia
Allopathic & Osteopathic Physicians / Urology 208800000X 0101236633 Virginia

Profile Details

NPI number 1134124035
LBN Legal business name Daniel, Charles Douglas
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 16th, 2005
Last updated Oct 21st, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1134124035 NPPES
Virginia MEDICAID 010085390

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