Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Charles Walter Southard

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1346047388

Charles Walter Southard is a Student in an Organized Health Care Education/Training Program in Riverhead, New York. Registered with an NPI since 2025.

In the registry since
2025

Practice location Address checks out

400 W Main St
Riverhead, NY 11901-2813
Phone: (631) 369-0104
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X

Record details

NPI number1346047388
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedFebruary 27, 2025
Last updated in NPPESFebruary 27, 2025
Certification dateFebruary 27, 2025

Other providers in Riverhead