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Individual

DR. CHARLES R PATTAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
11050 PARKVIEW CIRCLE DR, FORT WAYNE, IN 46845
(833) 724-8326
(260) 266-8941
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
4301051609
MI
207V00000X
Obstetrics & Gynecology Physician
Primary
01082842A
IN
207V00000X
Obstetrics & Gynecology Physician
4301051609
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2989963
MI
Enumeration date
01/08/2007
Last updated
05/10/2023
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