MEDICARE: CHARLES M. WASSERMAN DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	OS006559L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	4571206	OTHER	PA	AETNA PPO
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	0470055	OTHER	PA	CIGNA HMO/PPO
4	10938435	OTHER	PA	CAQH ID#
5	469591	OTHER	PA	AETNA HMO
6	080134444	OTHER	PA	RRM
7	694010	OTHER	PA	HIGHMARK BLUE SHIELD

General Provider Information

NPI Number	:	1093753949
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHARLES M. WASSERMAN DO

Provider Business Mailing Address
First Line	:	7500 CENTRAL AVE STE 104
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19111-2431
Country	:	US
Telephone Number	:	215-742-0712
Fax Number	:	215-742-5218

Provider Business Practice Location Address
First Line	:	7500 CENTRAL AVE STE 104
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19111-2431
Country	:	US
Telephone Number	:	215-742-0712
Fax Number	:	215-742-5218

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/03/2006
Last Update Date	:	05/14/2021

Similar Medicare Providers

1174593123 — FOX CHASE MEDICAL ASSOCIATES PC
Practice Location Address:

7500 CENTRAL AVENUE , SUITE 104
PHILADELPHIA, PA
19111-2431

Practice Phone: 215-742-0712
Practice Fax: 215-742-5218

1215973565 — MICHAEL S FAKHRAEE MD
Practice Location Address:

7500 CENTRAL AVE , SUITE 101
PHILADELPHIA, PA
19111-2431

Practice Phone: 215-728-8200
Practice Fax: 215-725-3209

1003836768 — MENG-CHAO LEE D.O.
Practice Location Address:

7500 CENTRAL AVE STE 104
PHILADELPHIA, PA
19111-2431

Practice Phone: 215-742-0712
Practice Fax: 215-742-5218

1316328057 — RUCHI BHUTANI M.D.
Practice Location Address:

7500 CENTRAL AVE STE 104
PHILADELPHIA, PA
19111-2431

Practice Phone: 215-742-2712
Practice Fax: 215-742-5218

1295245694 — HR PHYSICIAN SERVICES
Practice Location Address:

7500 CENTRAL AVE STE 108
PHILADELPHIA, PA
19111-2431

Practice Phone: 215-745-4050
Practice Fax: 215-745-9333

1699374413 — CHRISTINE JESSICA LUBY
Practice Location Address:

7500 CENTRAL AVE STE 104
PHILADELPHIA, PA
19111-2431

Practice Phone: 215-742-0712
Practice Fax: 215-742-5218

Directions to “ CHARLES M. WASSERMAN DO” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.