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General NPI Number Information
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NPI Number | 1700884558
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Entity Type | Individual
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Provider Name | CHARLES JEFFERSON MAUNEY D.P.M.
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Gender | Male
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Dates
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Enumeration Date | 07/13/2005
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Last Update Date | 02/18/2010
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Provider Practice Location Address
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Address Line | 707 N MORGAN ST
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City | SHELBY
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State | NC
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Zip | 28150-3840
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Country | US
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Telephone | 704-487-6672
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Fax | 704-487-7863
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Provider Business Mailing Address
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Address Line | 707 N MORGAN ST
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City | SHELBY
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State | NC
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Zip | 28150-3840
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Country | US
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Telephone | 704-487-6672
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Fax | 704-487-7863
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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 | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 102
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License Number State | NC
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