CHARLES FULLENWIDER (NPI# 1417299298) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417299298 |
| Entity Type | Individual |
| Full Name | CHARLES FULLENWIDER |
| Credential | M.D. |
| Practice Address |
8901 Rockville Pike Bethesda MD 20889-0001 |
| Mailing Address |
333 S 38th St Suite F Muskogee OK 74401-4937 |
| Practice Telephone | 3012954000 |
| Enumeration Date | 2013-03-20 |
| Last Update Date | 2019-07-26 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | 31587 | OK | Allopathic & Osteopathic Physicians |
| N | 208D00000X | General Practice | MD.33529 | AL | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 7050 Air Depot Blvd, Tinker Afb, OK 731458716 | 4057342778 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447245063 | Charles Berry Fullenwider | Neurological Surgery | 333 S 38th St, Suite F, Muskogee, OK 74401-4937 | 2005-09-20 |
| Street Address |
8901 ROCKVILLE PIKE |
| City | BETHESDA |
| State | MD |
| Zip Code | 20889-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730182775 | Robert Nee | Internal Medicine | 8901 Rockville Pike, Bethesda, MD 20889-3026 | 2005-05-23 |
| 1528668829 | Jessica R Wonn | Dietitian, Registered | 8901 Rockville Pike, Bethesda, MD 20889-0001 | 2020-10-27 |
| 1730790957 | Zaneta Kinga Corral | Dentist | 8901 Rockville Pike, Bethesda, MD 20889-0001 | 2020-08-11 |
| 1346865862 | Min Chen | Student in an Organized Health Care Education/Training Program | 8901 Rockville Pike, Bethesda, MD 20889-0001 | 2020-06-10 |
| 1902426422 | Rachel Hyeun Han | Student in an Organized Health Care Education/Training Program | 8901 Rockville Pike, Bethesda, MD 20889-0001 | 2020-04-24 |
| 1790313997 | Timothy Joseph Banks | Student in an Organized Health Care Education/Training Program | 8901 Rockville Pike, Bethesda, MD 20889-0001 | 2020-04-01 |
| 1801424080 | Charles Daniel Nicoli | Student in an Organized Health Care Education/Training Program | 8901 Rockville Pike, Bethesda, MD 20889-0001 | 2020-04-01 |
| 1346878626 | Lorener Brayboy | Social Worker | 8901 Rockville Pike, Bethesda, MD 20889-0001 | 2020-03-31 |
| 1467080788 | Herman Otto Ira Pfaeffle | Student in an Organized Health Care Education/Training Program | 8901 Rockville Pike, Bethesda, MD 20889-0001 | 2020-03-31 |
| 1386272805 | Zachary Cyrus Affrin | Student in an Organized Health Care Education/Training Program | 8901 Rockville Pike, Bethesda, MD 20889-0001 | 2020-03-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457987034 | Michael Franco | Student in an Organized Health Care Education/Training Program | Internal Medicine - Walter Reed Nmmc, 8901 Wisconsin Avenue, Bethesda, MD 20889 | 2020-03-16 |
| 1245862135 | Kay Tomashek | Pediatrics | National Military Medical Center, 8901 Rockville Pike, Bethesda, MD 20889 | 2020-02-07 |
| 1104470657 | Adam Pink | Dentist | 8901 Wisconsin Ave Building 9 Floor 2, Bethesda, MD 20889 | 2019-08-01 |
| 1659939155 | Matthew Heller | Student in an Organized Health Care Education/Training Program | Psychiatry Walter Reed National Military Medica, 8901 Wisconsin Avenue, Bethesda, MD 20889 | 2019-05-30 |
| 1891258034 | Jane Ann Crotteau | Student in an Organized Health Care Education/Training Program | Pediatrics Walter Reed National Military Medical Center, 8901 Wisconsin Avenue, Bethesda, MD 20889 | 2019-04-12 |
| 1417434341 | Andrea Baeder | Dentist | 8901 Wisconsin Ave Bldg 9, Floor 2, Bethesda, AA 20889 | 2018-07-24 |
| 1942741723 | John Vance | Orthotist | Wrnmmc Orthotics, 8901 Wisconsin Avenue, Bethesda, MD 20889 | 2017-03-14 |
| 1790225704 | Sylvia Best | Pharmacist | 8901 Wisconsin Avenue Wrnmmc-, Americas Building 19- Internal Medicine Suite 2820, Bethesda, MD 20889 | 2017-02-24 |
| 1255783767 | Ryan Kaye | Student in an Organized Health Care Education/Training Program | Nsa Bethesda, 8901 Wisconsin Ave, Bethesda, Md 20889, Fpo, AA 20889 | 2016-07-08 |
| 1366861221 | Tara Elizabeth Brown | Internal Medicine | 8901 Wisconsin Avenue Walter Reed Nmmc, Bethesda, MD 20889 | 2014-04-08 |
| Find all providers in zip 20889 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134596703 | Mark Esar Sobel | General Practice | 9401 Bulls Run Pkwy, Bethesda, MD 20817-2405 | 2015-08-30 |
| 1326487471 | David Espinoza | General Practice | Walter Reed Bethesda, 8901 Wsconsin Avenue, Bethesda, MD 20889-5600 | 2013-06-21 |
| 1982963757 | Richard Charles Matzkin | General Practice | 6204 Goodview Street, Bethesda, MD 20817-6102 | 2012-05-14 |
| 1639449184 | Agnes Lim | General Practice | 8104 Maple Ridge Rd, Bethesda, MD 20814-1359 | 2011-12-30 |
| 1134413883 | Walter Michael Kuehl | General Practice | 4853 Cordell Ave Apt 721, Bethesda, MD 20814-3023 | 2011-05-29 |
| 1457516379 | Henry Spencer Eden | General Practice | Building 13 Room 3n17 Msc #5766, Nih, Bethesda, MD 20892 | 2008-07-21 |
| 1952565947 | Charles J Bechert | General Practice | 5500 Johnson Ave, Bethesda, MD 20817-3518 | 2008-07-18 |
| 1013068592 | Zidi Berger | General Practice | 10215 Fernwood Rd Ste 402, Bethesda, MD 20817-1191 | 2007-01-13 |
| 1568029783 | Brian Gerstenslager | General Practice | 8901 Wisconsin Ave, Bethesda, MD 20889-0004 | 2019-05-22 |
| 1952758138 | Opeyemi Oluyemi | General Practice | Walter Reed National Military Ctr, 8901 Wisconsin Avenue, Bethesda, MD 20889-0001 | 2016-05-18 |
| Find all providers in BETHESDA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.