Individual
DR. CHARLES WESLEY BRANSFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
921 GREELEY ST S, STILLWATER, MN 55082-5935
(651) 439-1234
(651) 439-1928
Mailing address
8170 33RD AVE S # MS 21110Q, MINNEAPOLIS, MN 55425-4516
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
25254
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
304203100
—
MN
05
—
30453400
—
WI
Enumeration date
12/21/2005
Last updated
03/10/2021
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