MEDICARE: CHARLES E MEUSBURGER 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
1	2084P0800X	Psychiatry Physician	25MAO5491900	NJ

General Provider Information

NPI Number	:	1699849505
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHARLES E MEUSBURGER MD

Provider Business Mailing Address
First Line	:	3069 ENGLISH CREEK AVE
Second Line	:	SUITE 225
City	:	EGG HARBOR TOWNSHIP
State	:	NJ
Zip	:	08234-9708
Country	:	US
Telephone Number	:	609-484-0770
Fax Number	:	609-484-0701

Provider Business Practice Location Address
First Line	:	3069 ENGLISH CREEK AVE
Second Line	:	SUITE 225
City	:	EGG HARBOR TOWNSHIP
State	:	NJ
Zip	:	08234-9708
Country	:	US
Telephone Number	:	609-484-0770
Fax Number	:	609-484-0701

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

Provider Enumeration Date	:	11/20/2006
Last Update Date	:	01/22/2016

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