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NPI Code Detail

MEDICARE: DR. CHARLES HIRAM OLIVERA M.D.

MEDICARE: DR. CHARLES HIRAM OLIVERA M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084N0400XNeurology PhysicianDR.0059010CO
22084N0400XNeurology Physician37868AZ
32084N0400XNeurology PhysicianME 73103FL
42084N0400XNeurology PhysicianP4796TX
52084N0400XNeurology Physician12570PR

General Provider Information

NPI Number : 1457465528
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CHARLES HIRAM OLIVERA M.D.
Provider Business Mailing Address
First Line : 2400 S AVENUE A
Second Line :
City : YUMA
State : AZ
Zip : 85364-7170
Country : US
Telephone Number : 928-344-2000
Fax Number :
Provider Business Practice Location Address
First Line : 2400 S AVENUE A
Second Line :
City : YUMA
State : AZ
Zip : 85364-7170
Country : US
Telephone Number : 928-336-4577
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/18/2006
Last Update Date : 01/03/2025

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