Fred Henry Daniel Charles, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

4301507592 Issued in MI

Practice address

6001 W Outer Dr Ste 114
Detroit, MI 48235-2626

Phone

(313) 966-9444

Fax

(313) 966-9418

NPI assigned

May 19, 2020

Last updated

Oct 16, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1589846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697414400000",
    "number": "1609499193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25326 PENNSYLVANIA AVE",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483751784",
            "telephone_number": "203-820-5977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6001 W OUTER DR STE 114",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482352626",
            "telephone_number": "313-966-9444",
            "fax_number": "313-966-9418"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4201 Saint Antoine St # 9C",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482012153",
            "country_code": "US",
            "telephone_number": "313-966-0463",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHARLES",
        "first_name": "FRED",
        "middle_name": "HENRY DANIEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-05-19",
        "last_updated": "2023-10-16",
        "certification_date": "2023-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "4351047136",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301507592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charity Home Care Services, Inc
• Charlene Sharon Staff
• Charles Johnson DPM
• Charles M Johnson Podiatrist PC
• Alix Charles Jr., MD
• Jasmine Charles, M.S.W
• Nicole Diane Charles
• Patrick Anselm Charles, M.D.
• Juanita Charleston
• Camillia Lashawn Charley, LBSW

• Internal Medicine Physician in Detroit, MI
• Providers in Detroit, MI by specialty
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.