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Individual

GREGORY L. CHARLOP

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3645 HIGH GREEN DR, MARIETTA, GA 30068-2530
(650) 281-1297
Mailing address
3645 HIGH GREEN DR, MARIETTA, GA 30068-2530
(650) 281-1297

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
89911
GA
207L00000X
Anesthesiology Physician
Primary
A76196
CA
207L00000X
Anesthesiology Physician
S9275
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00A761960
CA
Enumeration date
11/01/2006
Last updated
11/02/2021
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