Provider Demographics
NPI:1447367271
Name:SPARKS, CHARLES E (MD)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:E
Last Name:SPARKS
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Gender:M
Credentials:MD
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Mailing Address - Street 1:601 ELMWOOD AVE
Mailing Address - Street 2:DEPARTMENT OF PATHOLOGY & LABORATORY MEDICINE
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14642-0001
Mailing Address - Country:US
Mailing Address - Phone:585-275-8236
Mailing Address - Fax:585-756-5337
Practice Address - Street 1:601 ELMWOOD AVE
Practice Address - Street 2:DEPARTMENT OF PATHOLOGY & LABORATORY MEDICINE
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14642-0001
Practice Address - Country:US
Practice Address - Phone:585-275-8236
Practice Address - Fax:585-756-5337
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2007-07-12
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Provider Licenses
StateLicense IDTaxonomies
NY150997207ZP0104X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0104XAllopathic & Osteopathic PhysiciansPathologyChemical Pathology