Individual
DR. CHARLES W TATE III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1380 E MEDICAL CENTER DR, STE 1500, ST GEORGE, UT 84790-2123
(435) 251-2500
(435) 656-4907
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
(435) 251-2500
(435) 656-4907
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
42885
CO
207RC0000X
Cardiovascular Disease Physician
42885
CO
207RC0001X
Clinical Cardiac Electrophysiology Physician
42885
CO
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
7724231-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
85581224
—
CO
Enumeration date
06/07/2006
Last updated
06/27/2016
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