Provider Demographics
NPI:1689010050
Name:SIMS, CHARLES COLSTON (MD)
Entity type:Individual
Prefix:
First Name:CHARLES
Middle Name:COLSTON
Last Name:SIMS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:147 ASHELAND AVE
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28801-4013
Mailing Address - Country:US
Mailing Address - Phone:828-258-1188
Mailing Address - Fax:
Practice Address - Street 1:147 ASHELAND AVE
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801
Practice Address - Country:US
Practice Address - Phone:828-258-1188
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-13
Last Update Date:2018-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2016-01181207R00000X
NC191979390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty