Individual
DR. CHARLES WILLIAM BARTHOLOME
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1808 W ROYALE DR, MUNCIE, IN 47304-2243
(765) 288-8188
(765) 282-7242
Mailing address
1808 W ROYALE DR, MUNCIE, IN 47304-2243
(765) 288-8188
(765) 282-7242
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
100348140
IN
207ND0101X
MOHS-Micrographic Surgery Physician
100348140
IN
207ND0900X
Dermatopathology Physician
100348140
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000084070
BLUE CROSS/BLUE SHIELD
IN
01
—
070002789
RAILROAD MEDICARE
—
05
—
100348140
—
IN
Enumeration date
06/02/2005
Last updated
05/29/2008
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