Redeker, Charles Conrad

Redeker, Charles Conrad is an individual health care provider with primary practice located at 325 Western Blvd , Jacksonville NC 28546-6341. He recently has only one registered license in Emergency Medical Service Providers / Emergency Medical Technician, Basic, which is considered as his primary health care specialty. Redeker, Charles Conrad can be contacted via phone (910) 577-1555.

Contact Information

Primary practice address
325 Western Blvd Jacksonville NC 28546-6341
Phone: (910) 577-1555
Fax: (910) 577-1841
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Emergency Medical Service Providers / Emergency Medical Technician, Basic 146N00000X 9300293 North Carolina

Profile Details

NPI number 1831219674
LBN Legal business name Redeker, Charles Conrad
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 29th, 2007
Last updated Sep 25th, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1831219674 NPPES
North Carolina MEDICAID 891074V
North Carolina Other 1088E

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