Individual
CHARLES E NUSSBAUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1100 9TH AVE, SEATTLE, WA 98101-2756
(206) 223-6600
Mailing address
1100 9TH AVE, MS:M4-PA, SEATTLE, WA 98101-2756
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
MD00027304
WA
208600000X
Surgery Physician
MD00027304
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0039591
LABOR & INDUSTRY
WA
01
—
140006459
RAILROAD MEDICARE
—
05
—
8118077
—
WA
01
—
MD8523W
ALASKA MEDICAID
WA
01
—
NU4423
BLUE SHIELD
WA
01
—
US0861499
AETNA/USHC SPECIALIST
WA
Enumeration date
08/14/2006
Last updated
06/04/2019
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