Individual
CHARLES MAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3577 W 13 MILE RD, STE. 101, ROYAL OAK, MI 48073-6710
(248) 551-0360
Mailing address
3601 W 13 MILE RD, 400-FSC/PCS, ROYAL OAK, MI 48073-6712
Taxonomy
Speciality
Code
Description
License number
State
2080P0207X
Pediatric Hematology & Oncology Physician
Primary
4301029133
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
350F361320
BCBSM
MI
05
—
6047247
—
MI
Enumeration date
03/25/2006
Last updated
11/19/2024
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