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General NPI Number Information
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NPI Number | 1023017555
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Entity Type | Individual
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Provider Name | CHARLES GORDON CALDWELL M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/18/2005
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Last Update Date | 11/04/2009
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Provider Practice Location Address
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Address Line | 514 E BRYAN ST
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City | SAVANNAH
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State | GA
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Zip | 31401-2803
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Country | US
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Telephone | 912-257-9884
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Fax |
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Provider Business Mailing Address
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Address Line | 514 E BRYAN ST
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City | SAVANNAH
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State | GA
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Zip | 31401-2803
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Country | US
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Telephone | 912-257-9884
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 14488
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License Number State | NH
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | D9381
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License Number State | TX
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