Wanich, Charles K

Wanich, Charles K is an individual health care provider with primary practice located at 245 S Courtenay Parkway Bldg B, Merritt Island FL 32952. He recently has only one registered license in Allopathic & Osteopathic Physicians / Nephrology, which is considered as his primary health care specialty. Wanich, Charles K can be contacted via phone (321) 453-5326.

Contact Information

Primary practice address
245 S Courtenay Parkway Bldg B Merritt Island FL 32952
Phone: (321) 453-5326
Fax: (321) 452-8507
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Nephrology 207RN0300X ME36933 Florida

Profile Details

NPI number 1376642355
LBN Legal business name Wanich, Charles K
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 22nd, 2006
Last updated Oct 26th, 2011 - 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 1376642355 NPPES
Other 110202974 RR MEDICARE
MEDICAID 039647800 RR MEDICARE
Other 2168973 RR MEDICARE

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