Individual
DR. CHARLES ARTHUR AMBELANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5666 E STATE ST, ROCKFORD, IL 61108-2425
(815) 226-2000
Mailing address
2799 W GRAND BLVD, DETROIT, MI 48202-2608
(920) 918-1602
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
53957-020
WI
2085R0202X
Diagnostic Radiology Physician
L2511673
MI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/21/2008
Last updated
12/13/2018
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