Individual
CHARLES J BAE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3624 MARKET ST STE 201, PHILADELPHIA, PA 19104-2614
(215) 662-7772
Mailing address
3624 MARKET ST, STE 201, PHILADELPHIA, PA 19104-2614
(215) 662-7772
Taxonomy
Speciality
Code
Description
License number
State
2084N0600X
Clinical Neurophysiology Physician
Primary
MD461584
PA
2084S0012X
Sleep Medicine (Psychiatry & Neurology) Physician
MD461584
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
130026373
MEDICARE RAILROAD
OH
05
—
2372847
—
OH
Enumeration date
06/06/2006
Last updated
07/21/2022
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