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Individual
CHARLES SCOTT NEEDHAM
Active
Individual
CHARLES SCOTT NEEDHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
10916
MT
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
188161-1205
UT
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
25878
NV
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
M-12600
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000092896
BCBS PIN
MT
01
—
0151589
MDCD PIN
MT
01
—
122226100
MDCD PIN
WY
Enumeration date
07/25/2006
Last updated
09/25/2024
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