Mhiku M Charles, CASE MANAGER

Individual provider Active NPI Case Manager/Care Coordinator · Waterbury, CT

NPI 1750688693 · NPPES record last updated Feb 11, 2011

Key facts

NPI
1750688693
Entity type
Individual (NPI type 1)
Primary specialty
Case Manager/Care Coordinator 171M00000X
License
CT (CT)
Practice address
402 E Main St
Waterbury, CT 06702-1701
Phone
(203) 574-3201
Fax
(203) 574-3274
NPI assigned
Feb 11, 2011
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

State licenses

LicenseStateTypeSpecialty
CTCTMDCase Manager/Care Coordinator

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X CT CT Yes

Addresses

Primary practice location

402 E Main St
Waterbury, CT 06702-1701

Mailing address

402 E Main St
Waterbury, CT 06702-1701
Phone (203) 574-3201

Other providers in Waterbury, CT

All providers in Waterbury, CT · Case Manager/Care Coordinator in Connecticut

Sources for this page

Verify at the official NPI Registry.