Basic Information
Provider Information
NPI: 1427031657
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ANDREWS
FirstName: CHARLES
MiddleName: F
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1020A E BOAL AVE
Address2:  
City: BOALSBURG
State: PA
PostalCode: 168271509
CountryCode: US
TelephoneNumber: 8142378627
FaxNumber: 8142380083
Practice Location
Address1: CEDAR CREST AND I78
Address2:  
City: ALLENTOWN
State: PA
PostalCode: 181036369
CountryCode: US
TelephoneNumber: 6104020700
FaxNumber:  
Other Information
ProviderEnumerationDate: 11/22/2005
LastUpdateDate: 12/10/2010
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2085R0001XMD027229EPAY Allopathic & Osteopathic PhysiciansRadiologyRadiation Oncology

ID Information
IDTypeStateIssuerDescription
P40058401PAOXFORDOTHER
102936901PAKEYSTONE MERCYOTHER
30001818401PARAILROAD MEDICAREOTHER
001089496000805PA MEDICAID
11206301PAMEDPLUS/THREE RIVERSOTHER
117770101PACAPITAL BCOTHER
8507200001PAKEYSTONE HEALTH PLAN EASTOTHER
102936901PAAMERIHEALTH MERCYOTHER
151915701PAGATEWAY HEALTH PLANOTHER
1522201PAGEISINGER HEALTH PLANOTHER
15684701PABCBS PAOTHER


Home