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General NPI Number Information
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NPI Number | 1235151309
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Entity Type | Individual
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Provider Name | CHARLES P. VIRDEN M.D., F.A.C.S.
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Gender | Male
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Dates
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Enumeration Date | 07/24/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 960 CAUGHLIN CROSSING N. SUITE #100
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City | RENO
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State | NV
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Zip | 89519
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Country | US
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Telephone | 775-348-9798
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Fax | 775-348-5809
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Provider Business Mailing Address
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Address Line | 960 CAUGHLIN CROSSING N. SUITE #100
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City | RENO
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State | NV
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Zip | 89519
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Country | US
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Telephone | 775-348-9798
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Fax | 775-348-5809
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 7420
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License Number State | NV
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