Provider Demographics
NPI:1447376397
Name:ANDREWS, CHARRON FENBERT (PT)
Entity type:Individual
Prefix:MS
First Name:CHARRON
Middle Name:FENBERT
Last Name:ANDREWS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:108 COTTONWOOD CT
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514-1629
Mailing Address - Country:US
Mailing Address - Phone:919-932-6734
Mailing Address - Fax:
Practice Address - Street 1:115 OAKDALE DR
Practice Address - Street 2:STE. 8
Practice Address - City:HILLSBOROUGH
Practice Address - State:NC
Practice Address - Zip Code:27278-9079
Practice Address - Country:US
Practice Address - Phone:919-732-6600
Practice Address - Fax:919-723-2779
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2013-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6164225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC250188Medicare PIN