Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RH0000X | Hematologist | 048068 | GA |
Y | 207RX0202X | Medical Oncology | 048068 | GA |
NPI | 1174503585 |
---|---|
Provider Name | Charles Henry Nash III |
First Address | Gainesville, GA 30503-0658 |
Second Address | Gainesville, GA 30501-3834 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/01/2006 |
Last Update Date | 07/03/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000847547A | (05) | GA |
000847547B | (05) | GA |
10044870 | AMERIGROUP (01) | GA |
110231727 | RR MEDICARE-GRP # CC4177 (01) | GA |
329963 | WELLCARE (01) | GA |
3600016 | UNITED HEALTHCARE (01) | GA |
3780410 | CIGNA (01) | GA |
52668899 | BCBS (01) | GA |
D42693 | (02) | GA |