Provider Demographics
NPI:1730193731
Name:SAYRE, CHARLES B (DC, NP-C)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:B
Last Name:SAYRE
Suffix:
Gender:M
Credentials:DC, NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 E RICH BLVD
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH CITY
Mailing Address - State:NC
Mailing Address - Zip Code:27909-5518
Mailing Address - Country:US
Mailing Address - Phone:828-286-3472
Mailing Address - Fax:252-333-1877
Practice Address - Street 1:135 E RICH BLVD
Practice Address - Street 2:
Practice Address - City:ELIZABETH CITY
Practice Address - State:NC
Practice Address - Zip Code:27909-5518
Practice Address - Country:US
Practice Address - Phone:252-333-1277
Practice Address - Fax:252-333-1877
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2020-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1955111N00000X
NC2677111NI0013X
NC5013429363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No111N00000XChiropractic ProvidersChiropractor
No111NI0013XChiropractic ProvidersChiropractorIndependent Medical Examiner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCU82395Medicare UPIN
NC2457511Medicare PIN
TN3970236Medicare PIN
TNU82395Medicare UPIN