Supernavage, Charles J
Supernavage, Charles J is an individual health care provider with primary practice located at 1800 Dual Hwy 303 , Hagerstown MD 21740-6648. He recently has only one registered license in Allopathic & Osteopathic Physicians / Otolaryngology, which is considered as his primary health care specialty. Supernavage, Charles J can be contacted via phone (301) 739-0400.Contact Information
Primary practice address
1800 Dual Hwy 303
Hagerstown MD 21740-6648
Phone: (301) 739-0400
Fax: (301) 739-0402
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Otolaryngology | 207Y00000X | D0026440 | Maryland |
Profile Details
| NPI number | 1720080963 |
|---|---|
| LBN Legal business name | Supernavage, Charles J |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 1st, 2005 |
| Last updated | Aug 10th, 2015 - 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 | 1720080963 | NPPES |
| Maryland | Other | 36496001 | CAREFIRST BLUE SHIELD ID |
| Maryland | Other | 770413 | CAREFIRST BLUE SHIELD ID |
| Maryland | MEDICAID | 314681200 | CAREFIRST BLUE SHIELD ID |
| Maryland | Other | 214080 | CAREFIRST BLUE SHIELD ID |
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