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General NPI Number Information
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NPI Number | 1265405963
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Entity Type | Individual
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Provider Name | CHARLES C MCNAIR MD
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Gender | Male
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Dates
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Enumeration Date | 02/12/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 40 MAIN ST N
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City | WOODBURY
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State | CT
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Zip | 06798-2966
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Country | US
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Telephone | 203-266-0080
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Fax | 203-263-3921
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Provider Business Mailing Address
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Address Line | 1625 STRAITS TPKE SUITE #201
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City | MIDDLEBURY
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State | CT
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Zip | 06762-1805
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Country | US
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Telephone | 203-573-9512
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Fax | 203-568-2904
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 021808
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License Number State | CT
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