Individual
CHARLES PRESTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
350 W THOMAS RD, ATTN: ACADEMIC AFFAIRS, PHOENIX, AZ 85013-4409
(602) 406-3538
Mailing address
350 W THOMAS RD, ATTN: ACADEMIC AFFAIRS, PHOENIX, AZ 85013-4409
(602) 406-3538
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
R70474
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R70474
TRAINING PERMIT
AZ
Enumeration date
06/18/2008
Last updated
06/18/2008
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