Healthcare Provider Details

I. General information

NPI: 1841364551
Provider Name (Legal Business Name): CHARLES A BUZZANELL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/17/2006
Last Update Date: 01/26/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

172 ASHELAND AVE SUITE C
ASHEVILLE NC
28801-4005
US

IV. Provider business mailing address

PO BOX 2449
ASHEVILLE NC
28802-2449
US

V. Phone/Fax

Practice location:
  • Phone: 828-350-9310
  • Fax: 828-350-9311
Mailing address:
  • Phone: 828-350-9310
  • Fax: 828-350-9311

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number0098-00481
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: