Individual
DR. JOHN CHARBONNEAU
Active
Individual
DR. JOHN CHARBONNEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2083X0100X
Occupational Medicine Physician
Primary
DR.0030255
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01302553
—
CO
01
—
P00944678
MEDICARE RAILROAD CARRIER PTAN
CO
Enumeration date
02/06/2006
Last updated
08/19/2016
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