Johnson, Charles Wade

Johnson, Charles Wade is an individual health care provider with primary practice located at 113 Comanche Rd , Fort Meade SD 57741-1002. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Johnson, Charles Wade can be contacted via phone (605) 347-7491.

Contact Information

Primary practice address
113 Comanche Rd Fort Meade SD 57741-1002
Phone: (605) 347-7491
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X

Profile Details

NPI number 1699224931
LBN Legal business name Johnson, Charles Wade
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 28th, 2016
Last updated Sep 28th, 2016 - about 10 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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