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Individual

CHARLES GREEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
931 E 86TH ST STE 104, INDIANAPOLIS, IN 46240-1852
(317) 257-1484
(317) 257-1488
Mailing address
931 E 86TH ST STE 104, INDIANAPOLIS, IN 46240-1852
(317) 257-1484
(317) 257-1488

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10005186A
IN
363A00000X
Physician Assistant
Primary

Other

Enumeration date
10/01/2024
Last updated
03/11/2026
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