Individual
MR. KEVIN KURT CHARLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
576 JEFFERSON AVE, FORT EUSTIS, VA 23604-1602
(757) 314-7500
Mailing address
576 JEFFERSON AVE, FORT EUSTIS, VA 23604-1602
(757) 314-7500
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110002248
VA
Other
Enumeration date
06/25/2007
Last updated
11/20/2014
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