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Individual

DR. CHARLES D MASKIELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
200 RED CREEK DR, SUITE 100, ROCHESTER, NY 14623-5264
(585) 334-0130
(585) 334-0213
Mailing address
PO BOX 278980, ROCHESTER, NY 14627-8980

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
130694
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000911908001
HEALTHNOW
NY
01
3136
BC/BS
NY
01
391785
MVP
NY
01
4345333
AETNA
NY
01
5900780
GHI
NY
01
MD142Z
PREFERRED CARE
NY
01
P010130694
BLUE CHOICE
NY
Enumeration date
06/28/2006
Last updated
04/18/2012
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