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Individual

DR. CHARLES JOHN BREX

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
450 VETERANS MEMORIAL PKWY, BLDG 4, EAST PROVIDENCE, RI 02914-5300
(401) 435-3400
(401) 435-3586
Mailing address
10 DAVOL SQ, SUITE 400, PROVIDENCE, RI 02903-4754
(401) 421-4000
(401) 272-1456

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD05092
RI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
003528
BLUE CHIP
RI
01
007057448
MEDICARE
RI
01
04-00513
UNITED HEALTH CARE
RI
01
050483739
GREAT-WEST HEALTH CARE
RI
01
110195915
RAILROAD MEDICARE
RI
01
12010315
MULTIPLAN
RI
01
2028069
HEALTH CARE VALUE MGT
RI
01
2477-0
BCBS OF RI
RI
01
404463
TUFTS HEALTH PLAN
RI
01
60785
HARVARD HEALTH PLAN
RI
05
7003045
RI
01
709004046
MEDICARE GROUP
RI
01
710041001
CIGNA
RI
Enumeration date
09/12/2005
Last updated
03/03/2011
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