Individual
DR. CHARLES MARTIN BUCHANAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
120 E HARRIS AVE, SAN ANGELO, TX 76903-5904
(325) 653-6741
(325) 659-0180
Mailing address
PO BOX 22000, SAN ANGELO, TX 76902-7200
(325) 658-1511
(325) 481-2165
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
H2275
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
168006802
—
TX
01
—
8W2108
BCBS
TX
Enumeration date
10/25/2006
Last updated
10/07/2010
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