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Individual

DR. CHARLES MAWULI GODO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D

Contact information

Practice address
36000 DARNALL LOOP, DEPARTMENT OF MEDICINE, FORT HOOD, TX 76544-5095
(254) 288-8580
Mailing address
3000 HYDRANGEA AVE, KILLEEN, TX 76549-4939
(312) 593-6700

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
M0092
TX
207R00000X
Internal Medicine Physician
TP516
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
I76343501
TX
01
M0092
TEXAS STATE MEDICAL LIC.
TX
Enumeration date
08/10/2006
Last updated
03/07/2017
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