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Contact Information

CHARLES B MIKELL III, MD
HSC T12
ROOM 080
STONY BROOK, NY11794-8122
 Phone: 631-444-1116
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Neurological Surgery

207T00000X 02 Physician/General Surgery
 

Student in an Organized Health Care Education/Training Program

390200000X
Indicates primary specialty

NPI Profile & details for CHARLES B MIKELL III · (Male)

NPI # 1124254917
Status Active
Credentials MD
Entity Individual
Enumeration date 06/07/2009
Last updated 09/27/2016 - About 10 years ago
Sole proprietor 1 No
Identifiers
  • KY License # TP008
  • NY License # 273606
Hospital affiliation(s)
  • ST CHARLES HOSPITAL - (Acute Care)
    200 BELLE TERRE ROAD
    PORT JEFFERSON, NY 11777
  • UNIVERSITY HOSPITAL ( STONY BROOK ) - (Acute Care)
    HEALTH SCIENCES CENTER SUNY
    STONY BROOK, NY 11794
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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