Individual
DR. CHARLES W DAESCHNER III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
600 MOYE BLVD, ECU PHYSICIANS PEDIATRIC OUTPATIENT CENTER, GREENVILLE, NC 27834-4300
(252) 744-2335
(252) 744-3811
Mailing address
PO BOX 751069, CHARLOTTE, NC 28275-1069
(252) 744-3520
(252) 744-3194
Taxonomy
Speciality
Code
Description
License number
State
2080P0207X
Pediatric Hematology & Oncology Physician
Primary
38754
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2672B
BCBS NC
NC
01
—
830006204
RAILROAD MEDICARE
NC
05
—
892672B
—
NC
Enumeration date
07/29/2005
Last updated
11/02/2011
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