Individual
CHARLES PURDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
141 W 22ND ST, SUITE 311, ANDERSON, IN 46016-4304
(765) 641-7100
(765) 641-7115
Mailing address
141 W 22ND ST, ANDERSON, IN 46016-4304
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01036931A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100099090
—
IN
05
—
100099090A
—
IN
Enumeration date
07/11/2006
Last updated
08/09/2022
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