Healthcare Provider Details

I. General information

NPI: 1184680027
Provider Name (Legal Business Name): CHARLES ARTHUR RULA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2006
Last Update Date: 01/22/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25892 N JAMES MADISON HWY
NEW CANTON VA
23123-2234
US

IV. Provider business mailing address

PO 220 25892 N. JAMES MADISON HWY
NEW CANTON VA
23123-0220
US

V. Phone/Fax

Practice location:
  • Phone: 434-581-3271
  • Fax: 434-581-1105
Mailing address:
  • Phone: 434-581-3271
  • Fax: 434-581-1105

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number0101025367
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number0101025367
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: