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Individual

CHARLES W BRIAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
600 MARY ST, EVANSVILLE, IN 47747-0001
(812) 450-3405
(812) 450-3099
Mailing address
PO BOX 3407, EVANSVILLE, IN 47733-3407
(812) 450-6815
(812) 450-6822

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
01050225A
IN
207P00000X
Emergency Medicine Physician
Primary
35.073088
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000378775
BCBS - MARY STREET
IN
01
000000380169
BCBS - GATEWAY
IN
05
200244470
IN
05
64112824
KY
Enumeration date
09/12/2006
Last updated
09/19/2022
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