Basic Information
| Provider Information | |||||||||
| NPI: | 1033165196 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CUTLER | ||||||||
| FirstName: | CHARLES | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1 FEDERAL ST # 200 | ||||||||
| Address2: | |||||||||
| City: | CAMDEN | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 081031088 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8563564924 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3 COOPER PLZ RM 215 | ||||||||
| Address2: | |||||||||
| City: | CAMDEN | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 081031438 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8563422439 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/26/2006 | ||||||||
| LastUpdateDate: | 10/20/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/20/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | MD016965E | PA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | 25MA11233600 | NJ | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 0045722000 | 01 | PA | AMERIHEALTH/INTERCOUNTY | OTHER | 30010610 | 01 | PA | KEYSTONE MERCY | OTHER | 4100033 | 01 | PA | AETNA PPO | OTHER | 0045722000 | 01 | PA | IBC - PC/KHPE | OTHER | 10925258 | 01 | PA | CAQH ID # | OTHER | P00064588 | 01 | PA | RRM | OTHER | 0006267070004 | 05 | PA | MEDICAID | 0019255 | 01 | PA | AETNA HMO | OTHER | 113664 | 01 | PA | PHCS | OTHER | 025666 | 01 | PA | HIGHMARK BLUE SHIELD | OTHER | 1235185 | 01 | PA | CIGNA HMO/PPO | OTHER | 68800 | 01 | PA | FIRST HEALTH | OTHER |