Individual
CHARLIE FERGUSON
Active
Individual
CHARLIE FERGUSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
11278
AL
207R00000X
Internal Medicine Physician
Primary
11278
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11278
MEDICAL LICENSE
AL
05
—
3823836
—
TN
01
—
51014730
BLUECROSS BLUE SHIELD
AL
01
—
51083625
BCBS
AL
01
—
930023562
RAILROAD MCR
—
01
—
E368
MEDICARE
AL
Enumeration date
12/16/2005
Last updated
02/06/2020
Update your record
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