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General NPI Number Information
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NPI Number | 1912325887
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Entity Type | Individual
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Provider Name | CHARLES ELLIOTT FOUCAR MD
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Gender | Male
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Dates
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Enumeration Date | 03/28/2014
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Last Update Date | 02/18/2025
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Provider Practice Location Address
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Address Line | 1500 E MEDICAL CENTER DR
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City | ANN ARBOR
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State | MI
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Zip | 48109-5000
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Country | US
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Telephone | 734-936-4000
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Fax |
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Provider Business Mailing Address
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Address Line | 800 BRADBURY DR SE STE 116
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City | ALBUQUERQUE
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State | NM
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Zip | 87106-4310
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Country | US
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Telephone | 505-272-1476
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Fax |
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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 | 207RH0000X
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Taxonomy Name | Hematology (Internal Medicine) Physician
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License Number | 4301114283
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207RH0000X
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Taxonomy Name | Hematology (Internal Medicine) Physician
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License Number | MD2022-0581
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License Number State | NM
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