Individual
DR. CHARLES OGUNRO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
145 HOSPITAL AVE, SUITE 211, DU BOIS, PA 15801-1462
(814) 375-2070
(814) 375-2076
Mailing address
145 HOSPITAL AVE, SUITE 211, DU BOIS, PA 15801-1462
(814) 375-2070
(814) 375-2076
Taxonomy
Speciality
Code
Description
License number
State
2084N0600X
Clinical Neurophysiology Physician
49598
KY
2084N0600X
Clinical Neurophysiology Physician
95-118
NM
2084N0600X
Clinical Neurophysiology Physician
Primary
MD036291L
PA
2084N0600X
Clinical Neurophysiology Physician
TP318
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0010358330005
—
PA
05
—
00237590
—
NY
05
—
7100413180
—
KY
Enumeration date
11/13/2006
Last updated
09/20/2016
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