Provider Demographics
NPI:1780757294
Name:CHARLAND, JAMES M (MD)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:M
Last Name:CHARLAND
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:442A GUY PARK AVE
Mailing Address - Street 2:
Mailing Address - City:AMSTERDAM
Mailing Address - State:NY
Mailing Address - Zip Code:12010
Mailing Address - Country:US
Mailing Address - Phone:518-842-0373
Mailing Address - Fax:518-842-0135
Practice Address - Street 1:442A GUY PARK AVE
Practice Address - Street 2:
Practice Address - City:AMSTERDAM
Practice Address - State:NY
Practice Address - Zip Code:12010
Practice Address - Country:US
Practice Address - Phone:518-842-0373
Practice Address - Fax:518-842-0135
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2014-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY173248207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01195293Medicaid
NY01195293Medicaid
NY56016AMedicare ID - Type Unspecified