Individual
DR. CHARLES PRADIEU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
100 S BLISS AVE, 100 SOUTH BLISS AVE, TAHLEQUAH, OK 74464-2512
(918) 458-3100
Mailing address
1743 ATHERTON AVE, 1743 ATHERTON AVE, ELMONT, NY 11003-1744
(516) 424-3216
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
15061
PR
Other
Enumeration date
11/02/2005
Last updated
01/10/2011
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