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Organization
PATRICK A. CHARLES MD PC
Active
Organization
PATRICK A. CHARLES MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PATRICK ANSELM CHARLES M.D. (PRESIDENT)
(313) 640-1250
Entity
Organization
Contact information
Practice address
18601 MACK AVE, DETROIT, MI 48236-3250
(313) 640-1250
(313) 640-1291
Mailing address
PO BOX 21158, DETROIT, MI 48221-0158
(313) 640-1250
(313) 640-1291
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301058495
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2876665
—
MI
Enumeration date
06/11/2006
Last updated
12/18/2007
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