Individual
DR. FRED HENRY DANIEL CHARLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6001 W OUTER DR STE 114, DETROIT, MI 48235-2626
(313) 966-9444
(313) 966-9418
Mailing address
25326 PENNSYLVANIA AVE, NOVI, MI 48375-1784
(203) 820-5977
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301507592
MI
390200000X
Student in an Organized Health Care Education/Training Program
4351047136
MI
Other
Enumeration date
05/19/2020
Last updated
10/16/2023
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