Nicholson, Charles Hathaway
Nicholson, Charles Hathaway is an individual health care provider with primary practice located at 4420 Lake Boone Trl , Raleigh NC 27607-7505. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Anesthesiology, Allopathic & Osteopathic Physicians / Interventional Pain Medicine. Allopathic & Osteopathic Physicians / Anesthesiology is his primary health care specialty. Nicholson, Charles Hathaway can be contacted via phone (919) 784-3034.Contact Information
Primary practice address
4420 Lake Boone Trl
Raleigh NC 27607-7505
Phone: (919) 784-3034
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anesthesiology | 207L00000X | 30439 | North Carolina |
| Allopathic & Osteopathic Physicians / Interventional Pain Medicine | 208VP0014X | 30439 | North Carolina |
Profile Details
| NPI number | 1609987502 |
|---|---|
| LBN Legal business name | Nicholson, Charles Hathaway |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 31st, 2006 |
| Last updated | Dec 11th, 2007 - about 17 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1609987502 | NPPES |
| North Carolina | MEDICAID | 89132EO | |
| North Carolina | Other | 6715093 | |
| North Carolina | Other | 21504 | |
| North Carolina | Other | 57289 | |
| North Carolina | Other | 132EO |
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