Individual
MR. MATTHEW J CHARLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
001688
CT
111N00000X
Chiropractor
Primary
3226
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050001688CT01
ANTHEM BLUE CROSS
CT
01
—
11618170
CAQH
CT
Enumeration date
11/01/2006
Last updated
05/06/2009
Update your record
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