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Individual
CHARLES STEPHEN PAINE JR.
Active
Individual
CHARLES STEPHEN PAINE JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
01036853
IN
208D00000X
General Practice Physician
Primary
28754
OK
Other
Enumeration date
04/17/2007
Last updated
10/30/2014
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