Individual
MR. CHARLES PAUL CONWAY JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
3540 E BASELINE RD, #130, PHOENIX, AZ 85042
(623) 251-7559
(480) 621-7043
Mailing address
3540 E BASELINE RD, #130, PHOENIX, AZ 85042
(623) 251-7559
(480) 621-7043
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
253135
AZ
Other
Enumeration date
01/31/2021
Last updated
01/31/2021
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