MEDICARE: DR. CHARLES WILLIAM TITONE M.D.

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
1	207W00000X	Ophthalmology Physician	200300097	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	133W8	OTHER	NC	BCBS PROV #

General Provider Information

NPI Number	:	1619930120
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHARLES WILLIAM TITONE M.D.

Provider Business Mailing Address
First Line	:	1011 WH SMITH BLVD
Second Line	:	SUITE 108
City	:	GREENVILLE
State	:	NC
Zip	:	27834-5052
Country	:	US
Telephone Number	:	252-355-7301
Fax Number	:	252-364-3140

Provider Business Practice Location Address
First Line	:	1011 WH SMITH BLVD
Second Line	:	SUITE 108
City	:	GREENVILLE
State	:	NC
Zip	:	27834-5052
Country	:	US
Telephone Number	:	252-355-7301
Fax Number	:	252-364-3140

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/07/2006
Last Update Date	:	09/18/2020

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