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Individual

DR. CHARLES J BREEN

Active
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Individual

DR. CHARLES J BREEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
30914
KY
174400000X
Specialist
35-06-7760-B
OH
207W00000X
Ophthalmology Physician
Primary
30914
KY
207W00000X
Ophthalmology Physician
35.067760
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0102347
OH
05
64309149
KY
Enumeration date
06/01/2005
Last updated
09/18/2018
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