Individual
DR. CHARLES RYAN VASQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3600 SPRUCE ST, MALONEY BUILDING, FLOOR 4, PHILADELPHIA, PA 19104-4211
(215) 662-6156
Mailing address
1928 SOUTH ST, APT. 2R, PHILADELPHIA, PA 19146-1477
(763) 913-6440
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MT206076
PA
Other
Enumeration date
06/10/2014
Last updated
06/10/2014
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