Individual
MR. CHARLES LUKE MAGNANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1211 VIRGINIA ST, GREENSBORO, NC 27401-1313
(336) 275-0927
Mailing address
1211 VIRGINIA ST, GREENSBORO, NC 27401-1313
(336) 275-0927
(336) 275-4834
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0010-10093
NC
363AS0400X
Surgical Physician Assistant
Primary
0010-10093
NC
Other
Enumeration date
01/10/2019
Last updated
02/29/2024
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