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Individual

DR. CHARLES D GANIME

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.P.M.

Contact information

Practice address
155 HOSPITAL RD, STE I, WINCHESTER, TN 37398-2495
(931) 968-9191
(931) 968-9081
Mailing address
155 HOSPITAL RD, STE I, WINCHESTER, TN 37398-2495
(931) 968-9191
(931) 968-9081

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
DPM0000000591
TN
213ES0103X
Foot & Ankle Surgery Podiatrist
DPM0000000591
TN
213ES0131X
Foot Surgery Podiatrist
DPM0000000591
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2740157
UNITED HEALTHCARE PROV. #
TN
05
3353680
TN
01
4043822
BCBS PROVIDER NUMBER
TN
01
7641364
AETNA PROVIDER NUMBER
TN
Enumeration date
06/08/2005
Last updated
12/06/2007
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