Individual provider · Type 1 NPI

Jerald Dietrich Charles, PA-C

Physician Assistant · Green Bay, WI

NPI number 1396284154 Active

Practice location

2845 Greenbrier Rd Ste 320
Green Bay, WI 54311-6519

Call (920) 288-8320 Map

Mailing address

PO Box 735044
Chicago, IL 60673-5044

Specialties and licenses

TaxonomyCodeLicense
Surgical Physician Assistant 363AS0400XNone listed
Physician Assistant Primary 363A00000X4028-023 (WI)

Physician Assistant: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, orde…

Another provider at this address

Other physician assistant providers in Green Bay

See all in Green Bay →

About NPI 1396284154

Jerald Dietrich Charles, PA-C's National Provider Identifier is 1396284154, issued on Feb 13, 2017. The primary taxonomy on file is Physician Assistant (363A00000X), and the practice location is in Green Bay, WI. The record was last updated on Oct 16, 2026.