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NPI Code Detail

MEDICARE: DR. RAYMOND IGOR CHARLES D.C.

MEDICARE: DR. RAYMOND IGOR CHARLES D.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractorDC 4292AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1AZ0241280OTHERAZBLUE CROSS BLUE SHIELD

General Provider Information

NPI Number : 1225086812
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RAYMOND IGOR CHARLES D.C.
Provider Business Mailing Address
First Line : 10620 N 71ST PL
Second Line : SUITE C
City : SCOTTSDALE
State : AZ
Zip : 85254-6703
Country : US
Telephone Number : 480-948-5217
Fax Number : 480-948-1749
Provider Business Practice Location Address
First Line : 10620 N 71ST PL
Second Line : SUITE C
City : SCOTTSDALE
State : AZ
Zip : 85254-6703
Country : US
Telephone Number : 480-948-5217
Fax Number : 480-948-1749
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/05/2006
Last Update Date : 07/08/2007

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