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CHARLES NEUMAN PETTY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
825 EASTLAKE AVE E, SEATTLE, WA 98109-4405
(206) 288-1000
Mailing address
PO BOX 50095, SEATTLE, WA 98145-5095

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD00016725
WA
207V00000X
Obstetrics & Gynecology Physician
MD00016725
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1443
INTERNAL ID-MOTOR VEHICLE ID
05
8100430
WA
Enumeration date
10/27/2006
Last updated
10/01/2009
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