Individual
MR. CHARLES W BRUNELLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
375 N EASTOWN RD, LIMA, OH 45807-2214
(419) 228-3500
(419) 228-6700
Mailing address
81 HAWTHORNE DR, LIMA, OH 45805-4074
(419) 999-1312
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
35042012
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0361335
—
OH
Enumeration date
02/01/2006
Last updated
07/26/2013
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