Organization
PAUL S. CHARNETSKY, M.D. P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAUL SCOTT CHARNETSKY M.D. (OWNER)
(623) 932-2200
Entity
Organization
Contact information
Practice address
13851 W LA MAR BLVD, SUITE B, GOODYEAR, AZ 85338-1389
(623) 932-2200
(623) 932-2242
Mailing address
13851 W LA MAR BLVD, SUITE B, GOODYEAR, AZ 85338-1389
(623) 932-2200
(623) 932-2242
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
20645
AZ
2080A0000X
Pediatric Adolescent Medicine Physician
20645
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20645
AZ STATE LICENSE
AZ
Enumeration date
07/18/2006
Last updated
04/20/2008
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