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Organization
JOHN CHARLTON PODIATRY PA
Active
Organization
JOHN CHARLTON PODIATRY PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN L CHARLTON III DPM (PRESIDENT)
(410) 433-1122
Entity
Organization
Contact information
Practice address
5013 ROLAND AVE, BALTIMORE, MD 21210-2295
(410) 433-1122
(410) 433-1122
Mailing address
5013 ROLAND AVE, BALTIMORE, MD 21210-2295
(410) 433-1122
(410) 433-1122
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
MD01077
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0906085
—
MD
01
—
10227357
AMERICAID
MD
01
—
1932205994/W299
CFBC/BS
MD
01
—
480033528
RRMC
MD
01
—
T304/1932205994
CAREFIRST BC/BS
MD
Enumeration date
01/21/2011
Last updated
01/21/2011
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