Individual
DR. CHARLES M. WASSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
461 W HURON ST, NOMC EMERCENCY CENTER, PONTIAC, MI 48341-1601
(248) 857-7440
(248) 857-6992
Mailing address
5029 HICKORY POINTE DR, ORCHARD LAKE, MI 48323-1516
(248) 681-6007
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
285836
NY
207P00000X
Emergency Medicine Physician
Primary
4301406119
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104494778
—
MI
Enumeration date
05/30/2006
Last updated
04/20/2017
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