| Provider / Organization | NPI | Date Certified |
|---|---|---|
| CHARLES WALKER FRY | 1750812517 | 2022-06-26 |
Charles Walker Fry is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1750812517. Registration indicates Charles Walker Fry is a provider of services with a specialization in Allopathic & Osteopathic Physicians, Radiology (Radiology: Pediatric Radiology, ) (Diagnostics/Imaging/Laboratory/Mammography, ) (Radiology Pediatric Radiology, Allopathic & Osteopathic Physicians) (Radiology, ) (Student, Health Care, Student in an Organized Health Care Education/Training Program) (Student in an Organized Health Care Education/Training Program, ) (All Other Specialties & Provider Types, ) (Student in an Organized Health Care Education/Training Program, Student, Health Care)
| Registration | PART-B:Y DME:Y HHA:Y PMD:Y |
| Entity Type | Individual |
| Provider Name | Charles Walker Fry M.D. |
| Practice Office Address | 3401 CIVIC CENTER BLVD PHILADELPHIA, PA US |
| Practice Office Telephone | 2155902564 |
| Mailing Address | 3401 CIVIC CENTER BLVD PHILADELPHIA, PA 191044319 US |
| Business Telephone | 2155902564 |
| Address | City / State | Phone / Fax |
|---|---|---|
| 5 Perryridge Rd | Greenwich, CT 068304608 | 2038633408 / 2038633446 |
| 111 Colchester Ave | Burlington, VT 054011473 | 8028470000 |
| Code | Practice | License No State |
|---|---|---|
| 2085P0229X PRIMARY | Allopathic & Osteopathic Physicians Radiology Radiology: Pediatric Radiology Diagnostics/Imaging/Laboratory/Mammography Radiology Pediatric Radiology Allopathic & Osteopathic Physicians Radiology | MT224955
PA |
| 390200000X | Student, Health Care Student in an Organized Health Care Education/Training Program Student in an Organized Health Care Education/Training Program All Other Specialties & Provider Types Student in an Organized Health Care Education/Training Program Student, Health Care |