Individual
CHARLES BERNARD MCCANNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3450 ZAFARANO DR, STE C, SANTA FE, NM 87507-2669
(505) 466-5885
(505) 466-5886
Mailing address
2063 PLACITA DE VIDA, SANTA FE, NM 87505-5488
(505) 946-8790
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
NM 76-67
NM
208D00000X
General Practice Physician
76-67
NM
Other
Enumeration date
02/05/2007
Last updated
01/19/2017
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