Provider Demographics
NPI:1548439078
Name:BILBO, CHARLES E (NAVY IDC)
Entity type:Individual
Prefix:
First Name:CHARLES
Middle Name:E
Last Name:BILBO
Suffix:
Gender:M
Credentials:NAVY IDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:91-1184 LUKAHIU PL
Mailing Address - Street 2:
Mailing Address - City:EWA BEACH
Mailing Address - State:HI
Mailing Address - Zip Code:96706-4503
Mailing Address - Country:US
Mailing Address - Phone:808-655-3117
Mailing Address - Fax:
Practice Address - Street 1:91-1184 LUKAHIU PL
Practice Address - Street 2:
Practice Address - City:EWA BEACH
Practice Address - State:HI
Practice Address - Zip Code:96706-4503
Practice Address - Country:US
Practice Address - Phone:808-655-3117
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-28
Last Update Date:2008-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171000000XOther Service ProvidersMilitary Health Care Provider