Alderdice, Charles Ray

Alderdice, Charles Ray is an sole proprietor health care provider with primary practice located at 1906 Langley Ave , Saint Joseph MI 49085-1739. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Alderdice, Charles Ray can be contacted via phone (269) 982-1722.

Contact Information

Primary practice address
1906 Langley Ave Saint Joseph MI 49085-1739
Phone: (269) 982-1722
Fax: (269) 982-1842
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 5101008526 Michigan

Profile Details

NPI number 1821056649
LBN Legal business name Alderdice, Charles Ray
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 2nd, 2006
Last updated Jul 1st, 2010 - about 15 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 1821056649 NPPES
Michigan Other 015110022 BS
Michigan MEDICAID 1607063 BS
Michigan Other 010012749 BS
Michigan Other 134870500 BS
Michigan Other 382531804 BS

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