Individual
DR. DOUGLAS ALLAN CHARLESWORTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2104 W SAYBROOK DR, GOSHEN, IN 46528-5709
(574) 534-4023
Mailing address
2104 W SAYBROOK DR, GOSHEN, IN 46528-5709
(574) 534-4023
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01036465A
IN
Other
Enumeration date
08/05/2006
Last updated
07/08/2007
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