Provider Demographics
NPI:1144264052
Name:CHARFEN, CHARLOTTE (MD)
Entity type:Individual
Prefix:
First Name:CHARLOTTE
Middle Name:
Last Name:CHARFEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CHARLOTTE
Other - Middle Name:NEWMAN
Other - Last Name:CHARFEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:5665 NEW NORTHSIDE DR NW
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30328-5831
Mailing Address - Country:US
Mailing Address - Phone:770-874-5400
Mailing Address - Fax:
Practice Address - Street 1:54-3858 AKONI PULE HWY
Practice Address - Street 2:
Practice Address - City:KAPAAU
Practice Address - State:HI
Practice Address - Zip Code:96755
Practice Address - Country:US
Practice Address - Phone:808-726-2461
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2022-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA060566207P00000X
SC24006207P00000X
FLME97458207P00000X
TXP1736207P00000X
HIMD-18108207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA642990011AMedicaid
SCT84076Medicaid
SCH937962986Medicare PIN
SCH937962987Medicare PIN
H93796Medicare UPIN
GA642990011AMedicaid