# MR. MATTHEW J CHARLES

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1134206808
- **Gender:** Man
- **Credential:** D.C.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | 001688 | CT | — |
| 111N00000X | Chiropractor | 3226 | MA | Yes |

## Other

- **Enumeration date:** 11/01/2006
- **Last updated:** 05/06/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 050001688CT01 | ANTHEM BLUE CROSS | CT |
| 01 | — | 11618170 | CAQH | CT |