Healthcare Provider Details

I. General information

NPI: 1144264052
Provider Name (Legal Business Name): CHARLOTTE CHARFEN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHARLOTTE NEWMAN CHARFEN MD

II. Dates (important events)

Enumeration Date: 06/15/2006
Last Update Date: 12/08/2022
Certification Date: 12/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

54-3858 AKONI PULE HWY
KAPAAU HI
96755
US

IV. Provider business mailing address

5665 NEW NORTHSIDE DR NW
ATLANTA GA
30328-5831
US

V. Phone/Fax

Practice location:
  • Phone: 808-726-2461
  • Fax:
Mailing address:
  • Phone: 770-874-5400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number060566
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number24006
License Number StateSC
# 3
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberME97458
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberP1736
License Number StateTX
# 5
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD-18108
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: