Charles Albert Huibregtse, MD PHD
Individual provider Active NPI Family Medicine Physician · Redgranite, WI
NPI 1336204643 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1336204643
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 41116-020 (WI)
- Practice address
- 1600 County Rd Ee
Redgranite Correctional Institution
Redgranite, WI 54970-0900 - Phone
- (920) 566-3167
- Fax
- (920) 566-3166
- NPI assigned
- Dec 27, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Medicine, Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 41116-020 | WI | MD | Family Medicine Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 41116-020 | WI | Yes |
Addresses
Primary practice location
1600 County Rd Ee
Redgranite Correctional Institution
Redgranite, WI 54970-0900
Mailing address
PO Box 900
1600 County Rd Ee
Redgranite, WI 54970-0900
Phone (920) 566-3167
Other providers in Redgranite, WI
- Community Healt Network
- Robert B Devermann
- Eric Boettcher, S.C.
- Terry L Hankey
- Christine Hohenstein
- Lori Augusta Larsen
- Craig Dennis Maskil
- Renee Schmidt
- Thedacare Medical Center - Berlin, Inc.
- Mary Ellen Weidner-Ruediger
All providers in Redgranite, WI · Family Medicine Physician in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.