Individual
CHARLES E HANSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1513 PARK AVE, 1ST FLOOR, COLUMBUS, WI 53925-1618
(920) 623-9611
(920) 623-1788
Mailing address
1513 PARK AVE, COLUMBUS, WI 53925-1618
(920) 623-9611
(920) 623-1788
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
19782-020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1000156
PHYSICIANS PLUS
WI
Enumeration date
05/10/2006
Last updated
04/30/2014
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