Provider Demographics
NPI:1003347519
Name:WEDDINGTON, CHARLES MAXWELL (MD)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:MAXWELL
Last Name:WEDDINGTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2299 POST ST STE 312
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-3475
Mailing Address - Country:US
Mailing Address - Phone:415-292-6350
Mailing Address - Fax:
Practice Address - Street 1:2299 POST ST STE 312
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-3475
Practice Address - Country:US
Practice Address - Phone:415-292-6350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-26
Last Update Date:2025-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0095080207N00000X
IL125071373207R00000X
IL125.071373207R00000X
CAA203497207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine