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General NPI Number Information
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NPI Number | 1619950557
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Entity Type | Individual
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Provider Name | CHARLES GIBBS MAKER MD
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Gender | Male
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Dates
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Enumeration Date | 11/23/2005
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Last Update Date | 01/26/2024
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Provider Practice Location Address
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Address Line | 643 5TH AVE W
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City | HENDERSONVILLE
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State | NC
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Zip | 28739-4205
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Country | US
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Telephone | 828-694-7700
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Fax | 828-694-7701
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Provider Business Mailing Address
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Address Line | 643 5TH AVE W
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City | HENDERSONVILLE
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State | NC
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Zip | 28739-4205
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Country | US
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Telephone | 828-694-7700
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Fax | 828-694-7701
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 2021-00963
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 48633
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License Number State | MA
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