Individual
DR. CHARLES A. MANGHAM JR.
Active
Individual
DR. CHARLES A. MANGHAM JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, MS
Taxonomy
Speciality
Code
Description
License number
State
207YX0901X
Otology & Neurotology Physician
Primary
MD00013302
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1130606
—
WA
01
—
MD00013302
STATE MEDICAL LICENSE
WA
Enumeration date
04/03/2006
Last updated
03/07/2023
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