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Individual

DR. CHARLES REDMOND BREED

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2055 E SOUTHERN AVE, SUITE F, TEMPE, AZ 85282-7507
(480) 897-8484
(480) 897-8631
Mailing address
2055 E SOUTHERN AVE, SUITE F, TEMPE, AZ 85282-7507
(480) 897-8484
(480) 897-8631

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
10034
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00004310
BANNER HEALTH PLANS
AZ
01
1Z1867
HEALTHNET
AZ
05
207713
AZ
01
628739
VA BCBS
AZ
Enumeration date
09/28/2005
Last updated
09/27/2007
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