DR. CHARLES J SUPERNAVAGE (NPI# 1720080963) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720080963 |
| Entity Type | Individual |
| Full Name | DR. CHARLES J SUPERNAVAGE |
| Credential | MD |
| Practice Address |
1800 Dual Hwy 303 Hagerstown MD 21740-6648 |
| Mailing Address |
1800 Dual Highway Suite 303 Hagerstown MD 21740-6602 |
| Practice Telephone | 3017390400 |
| Practice Fax Number | 3017390402 |
| Mailing Telephone | 3017390400 |
| Mailing Fax Number | 3017390402 |
| Enumeration Date | 2005-06-01 |
| Last Update Date | 2015-08-10 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Y00000X | Otolaryngology | D0026440 | MD | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MD | 314681200 | 05 | |
| MD | MAMSI ID # | 214080 | 01 |
| MD | CAREFIRST BLUE SHIELD ID | 36496001 | 01 |
| AETNA ID # | 770413 | 01 |
| Street Address |
1800 DUAL HWY 303 |
| City | HAGERSTOWN |
| State | MD |
| Zip Code | 21740-6648 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548877426 | Shaynee Ann Barcelona Araneta | Physical Medicine & Rehabilitation | 17303 Kilpatrick Ct, Hagerstown, MD 21740 | 2020-09-25 |
| 1265081319 | Jes Right Care Dba Right At Home | In Home Supportive Care | 223 N. Pospect Street, Suite 203, Hagerstown, MD 21740 | 2019-09-10 |
| 1649828633 | Ihuoma Marvelous Udeagha | Nurse Practitioner | West Virginia University Medicine Brain & Spine, 13 Western Maryland Parkway, Ste 106, Hagerstown, MD 21740 | 2019-09-03 |
| 1831651157 | Rankin Physical Therapy, Inc. | Clinic/Center | 18348 Spark Drive, Suite 203, Hagerstown, MD 21740 | 2019-04-04 |
| 1285195586 | Ultimate Hearing Solutions Vi, LLC | Audiologist-Hearing Aid Fitter | 222 East Oak Ridge Dr. South Point Shopping Center, Suite 1850, Hagerstown, MD 21740 | 2019-03-28 |
| 1285108001 | Alternative Drig & Alcohol Counseling LLC | Counselor | 339 E Antietam Street, Hagerstown, MD 21740 | 2019-01-15 |
| 1093287617 | Brooke's House, Inc. | Clinic/Center | 17670 Technology Boulevard, Hagerstown, MD 21740 | 2018-12-20 |
| 1871096487 | Ashley Lawal | Behavioral Analyst | 649 Guilford Ave, Hagerstown, MD 21740 | 2018-03-10 |
| 1194231738 | Btst Services LLC | Community/Behavioral Health | 1301 W Washington St, 101, Hagerstown, MD 21740 | 2017-12-19 |
| 1811408057 | Compassionate Wellness Center, LLC | Nurse Practitioner | 44 N Potomac St Ste 101&102, Hagerstown, MD 21740 | 2017-10-16 |
| Find all providers in zip 21740 | ||||
| Taxonomy Code | 207Y00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598034183 | Edward John Drawbaugh | Otolaryngology | 19004 Cherry Tree Dr, Hagerstown, MD 21742-2633 | 2011-12-28 |
| 1386606234 | Bibhas C Bandy | Otolaryngology | 363 S Cleveland Ave, Suite 202, Hagerstown, MD 21740-5747 | 2006-04-05 |
| 1548242100 | Kirby J Scott | Otolaryngology | 1800 Dual Hwy, Suite #303, Hagerstown, MD 21740-6602 | 2005-11-18 |
| 1538400536 | Central Sinus Center, LLC | Otolaryngology | 1800 Dual Hwy, Suite 303, Hagerstown, MD 21740-6602 | 2013-03-15 |
| 1205122793 | Central Ent Consultants, PC | Otolaryngology | 1800 Dual Hwy, Suite 303, Hagerstown, MD 21740-6602 | 2011-06-22 |
| 1558568857 | Nathan Allen Deckard | Otolaryngology | 1800 Dual Hwy Ste 303, Hagerstown, MD 21740-6648 | 2007-06-29 |
| 1538213715 | Hagerstown Ear Nose & Throat Associates | Otolaryngology | 363 S Cleveland Ave, Suite 202, Hagerstown, MD 21740-5747 | 2007-01-23 |
| 1205891033 | Angela C. Stonebraker | Otolaryngology | 11110 Medical Campus Rd, Suite 126, Hagerstown, MD 21742-6700 | 2006-04-17 |
| 1356332480 | Anthony Christopher Manilla | Otolaryngology | 11110 Medical Campus Rd, Sutie 126, Hagerstown, MD 21742-6700 | 2005-10-28 |
| 1801898002 | Jarl Thomas Wathne | Otolaryngology | 11110 Medical Campus Rd, Ste 126, Hagerstown, MD 21742-6799 | 2005-06-01 |
| Find all providers in HAGERSTOWN | ||||
| City | HAGERSTOWN |
| Zip Code | 21740 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.