Healthcare Provider Details

I. General information

NPI: 1720389216
Provider Name (Legal Business Name): DONALD R CHARLTON HEARING AID FITTER
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/15/2010
Last Update Date: 11/15/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

221 SIPLE ST
PITTSBURGH PA
15239-1015
US

IV. Provider business mailing address

PO BOX 14207
PITTSBURGH PA
15239-0207
US

V. Phone/Fax

Practice location:
  • Phone: 412-795-9711
  • Fax: 412-373-5041
Mailing address:
  • Phone: 412-795-9711
  • Fax: 412-373-5041

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License NumberF02613
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: