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Individual

DR. CHARLTON E STUCKEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1401 NW 9TH AVE, BOCA RATON, FL 33486-1304
(561) 395-5733
Mailing address
2828 S SEACREST BLVD, SUITE 216, BOYNTON BEACH, FL 33435-7944
(561) 395-2117

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
233111
MA
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
ME115536
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
233111
MA
Enumeration date
04/29/2008
Last updated
12/02/2013
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