Middleton, Charles H
Middleton, Charles H is an individual health care provider with primary practice located at 4302 E State Blvd , Fort Wayne IN 46815-6988. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Middleton, Charles H can be contacted via phone (260) 484-3136.Contact Information
Primary practice address
4302 E State Blvd
Fort Wayne IN 46815-6988
Phone: (260) 484-3136
Fax: (260) 484-3137
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | 12008119 | Indiana |
Profile Details
| NPI number | 1093902264 |
|---|---|
| LBN Legal business name | Middleton, Charles H |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 1st, 2007 |
| Last updated | Mar 31st, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1093902264 | NPPES |
| Indiana | MEDICAID | 100079660A | |
| Indiana | Other | 000055165 |
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