Individual
CHARLES G MARESH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
51 WILLIAM B GRAHAM CT, KILMARNOCK, VA 22482-3852
(804) 435-0575
(804) 435-9017
Mailing address
51 WILLIAM B GRAHAM CT, KILMARNOCK, VA 22482-3852
(804) 435-0575
(804) 435-9017
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101027085
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010139996
—
VA
01
—
1669452090
CMS
—
Enumeration date
01/20/2006
Last updated
02/23/2024
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