Individual
DR. CHARLES A MATHIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
500 ARCADE AVE STE 400, ELKHART, IN 46514-2477
(574) 522-2284
(574) 522-3952
Mailing address
3245 HEALTH DR STE 100, GRANGER, IN 46530-1380
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
01041130A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200860370
—
IN
Enumeration date
06/09/2005
Last updated
05/01/2023
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