Dodge, Charles William

Dodge, Charles William is an individual health care provider with primary practice located at 123 S Washington St , Owosso MI 48867-2921. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) is his primary health care specialty. Dodge, Charles William can be contacted via phone (989) 723-0330.

Contact Information

Primary practice address
123 S Washington St Owosso MI 48867-2921
Phone: (989) 723-0330
Fax: (989) 723-0327
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 6401005935 Michigan
Behavioral Health & Social Service Providers / Professional 101YP2500X 6401005935 Michigan

Profile Details

NPI number 1295940690
LBN Legal business name Dodge, Charles William
Credentials PLC
Entity Individual
Sole proprietor 1 No
Enumeration date May 11th, 2007
Last updated Jul 9th, 2007 - about 19 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 1295940690 NPPES
Michigan MEDICAID 1016541

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