Individual
DR. CHARLES RICHARD SOUTHWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
GENESYS PARKWAY, GRAND BLANC, MI 48439, GRAND BLANC, MI 48439
(810) 606-5000
Mailing address
GENESYS PARKWAY, GRAND BLANC, MI 48439, GRAND BLANC, MI 48439
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
5151017881
MI
Other
Enumeration date
05/04/2026
Last updated
05/04/2026
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