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Individual

CHARLES M HARVEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
975 E. THIRD ST, CHATTANOOGA, TN 37403-2147
(423) 788-7608
(423) 778-2360
Mailing address
PO BOX 11225, CHATTANOOGA, TN 37401-2225
(423) 892-5602
(423) 892-5838

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN47005
TN
367500000X
Certified Registered Nurse Anesthetist
Primary
APN8989
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000556718A
GA
05
009709970
AL
01
3049766
BLUE CROSS BLUE SHIELD TN
TN
05
3601730
TN
01
430027336
RAILROAD MEDICARE
TN
05
8052357
NC
01
N369568
WELLCARE (GA MEDICAID)
GA
Enumeration date
12/04/2006
Last updated
02/01/2010
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