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Individual

DR. CHARLES E BRONDOS

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
715 S COWLEY ST, SUITE 224, SPOKANE, WA 99202-1375
(509) 624-9154
(509) 838-0102
Mailing address
715 S COWLEY ST, SUITE 224, SPOKANE, WA 99202-1375
(509) 624-9154
(509) 838-0102

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
13652
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1045905
WA
01
31507
LABOR AND INDUSTRIES
WA
05
35-9723
MT
01
E01073
ASURIS
01
KA634
BLUE CROSS OF IDAHO
ID
Enumeration date
06/20/2006
Last updated
07/09/2007
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