Basic Information
| Provider Information | |||||||||
| NPI: | 1275580227 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HOWELL | ||||||||
| FirstName: | CHARLES | ||||||||
| MiddleName: | D | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | GEORGIA AVE NW TOWER 6101 | ||||||||
| Address2: | |||||||||
| City: | WASHINGTON | ||||||||
| State: | DC | ||||||||
| PostalCode: | 200600001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2028656679 | ||||||||
| FaxNumber: | 2028653138 | ||||||||
| Practice Location | |||||||||
| Address1: | 2041 GEORGAI AVE NW TOWER 5001 | ||||||||
| Address2: | |||||||||
| City: | WASHINGTON | ||||||||
| State: | DC | ||||||||
| PostalCode: | 20060 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2028656620 | ||||||||
| FaxNumber: | 2028654607 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/27/2006 | ||||||||
| LastUpdateDate: | 11/08/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RG0100X | D46031 | MD | N | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology | 207R00000X | MD042011 | DC | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 6000524000 | 05 | WV | MEDICAID | 1275580227 | 05 | DE | MEDICAID | 532912-02 & 01 | 01 | MD | BLUE CROSS/BLUE SHIELD | OTHER | 124271700 | 05 | MD | MEDICAID | 4422880 | 05 | DC | MEDICAID |