Individual
JEAN B CHARLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2110 DORCHESTER AVE, SUITE 306, DORCHESTER CENTER, MA 02124-5628
(617) 296-1828
(617) 296-5717
Mailing address
PO BOX 365481, HYDE PARK, MA 02136-0009
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
056584
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3071413
—
MA
Enumeration date
06/19/2007
Last updated
07/08/2007
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