Healthcare Provider Details

I. General information

NPI: 1902397680
Provider Name (Legal Business Name): AIDAN THURIAN CHARLES MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/29/2018
Last Update Date: 09/17/2025
Certification Date: 09/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 4TH STREET SW
MASON CITY IA
50401-2800
US

IV. Provider business mailing address

PO BOX 674721
DALLAS TX
75267-4721
US

V. Phone/Fax

Practice location:
  • Phone: 641-428-7000
  • Fax:
Mailing address:
  • Phone: 515-643-2519
  • Fax: 515-643-5816

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License NumberMD53742
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: