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Individual

CHARLES A EVERLY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
75 BEEKMAN ST, PLATTSBURGH, NY 12901-1438
(518) 562-7371
(518) 562-7372
Mailing address
PO BOX 2868, PLATTSBURGH, NY 12901-0259
(518) 562-7900
(518) 562-7933

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
264696
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
528200
AHCCCS
01
930128016
RAILROAD
Enumeration date
10/16/2006
Last updated
11/11/2014
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