Healthcare Provider Details

I. General information

NPI: 1750351276
Provider Name (Legal Business Name): CHARLES ANTHONY FROSOLONE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 01/26/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

US NAVAL HOSPITAL SIGONELLA PSC 836 BOX 2670
FPO AE
09636
IT

IV. Provider business mailing address

US NAVAL HOSPITAL SIGONELLA PSC 836 BOX 44
FPO AE
09636
IT

V. Phone/Fax

Practice location:
  • Phone: 01139095563842
  • Fax:
Mailing address:
  • Phone: 01139095564627
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberG45047
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: