Individual provider Active NPI

Charles Dante Wowkanech, MD

  • Emergency Medicine Physician
  • Bethlehem, PA
National Provider Identifier
1033800818
Registry record updated Jun 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MT228191 Issued in PA
Practice address
2545 Schoenersville Rd
Bethlehem, PA 18017-7300
Phone
(484) 884-2489
NPI assigned
May 15, 2023
Last updated
Jun 13, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X MT228191 PA
Emergency Medicine Physician 207P00000X MT228191 PA Primary

Addresses

Primary practice location

2545 Schoenersville Rd
Bethlehem, PA 18017-7300

Mailing address

18 Gilbert LN
Ocean City, NJ 08226-2640
Phone (609) 513-5113

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230525003423 PA Order and Referring Only - Emergency MedicinePractitioner - Emergency Medicine 9234595729

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1684108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686614400000",
    "number": "1033800818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 GILBERT LN",
            "city": "OCEAN CITY",
            "state": "NJ",
            "postal_code": "082262640",
            "telephone_number": "609-513-5113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2545 SCHOENERSVILLE RD",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180177300",
            "telephone_number": "484-884-2489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOWKANECH",
        "first_name": "CHARLES",
        "middle_name": "DANTE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-05-15",
        "last_updated": "2023-06-13",
        "certification_date": "2023-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PA",
            "license": "MT228191",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "MT228191",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethlehem, PA

Sources for this page

Verify at the official NPI Registry.