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NPI Code Detail

MEDICARE: DR. MIKE EDSON CHARLES MD

MEDICARE: DR. MIKE EDSON CHARLES MD
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
1208000000XPediatrics PhysicianMD477764PA
22080P0202XPediatric Cardiology Physician25MA13148200NJ

General Provider Information

NPI Number : 1487117479
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MIKE EDSON CHARLES MD
Provider Business Mailing Address
First Line : 331 NEWMAN SPRINGS ROAD
Second Line : BLDG. 2, SUITE 220
City : RED BANK
State : NJ
Zip : 07701
Country : US
Telephone Number : 732-807-0877
Fax Number : 201-751-1680
Provider Business Practice Location Address
First Line : 3401 CIVIC CENTER BLVD
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19104-4319
Country : US
Telephone Number : 856-803-7907
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/08/2019
Last Update Date : 05/26/2026

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Directions to “ DR. MIKE EDSON CHARLES MD” Practice Location

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