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NPI Code Detail

MEDICARE: DR. CHARLES ROBERT HARMUTH MD

MEDICARE: DR. CHARLES ROBERT HARMUTH 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
1208VP0000XPain Medicine PhysicianMD11931TN
22084A0401XAddiction Medicine (Psychiatry & Neurology) PhysicianMD11931TN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
14105336OTHERTNBLUE SHIELD OF TN
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
34275839OTHERTNAETNA PPO

General Provider Information

NPI Number : 1487634853
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CHARLES ROBERT HARMUTH MD
Provider Business Mailing Address
First Line : PO BOX 299
Second Line :
City : MANCHESTER
State : TN
Zip : 37349-0299
Country : US
Telephone Number : 931-728-5607
Fax Number : 931-728-8354
Provider Business Practice Location Address
First Line : 2345 MURFREESBORO HWY
Second Line :
City : MANCHESTER
State : TN
Zip : 37355-3206
Country : US
Telephone Number : 931-728-5607
Fax Number : 931-728-8354
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/20/2006
Last Update Date : 09/11/2025

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