MEDICARE: DR. CHARLES J VEALE MD

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
1	207Q00000X	Family Medicine Physician	10204	AL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	080146617	OTHER	AL	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	051048983	OTHER	AL	BC ALL LOCATIONS
3	631224199	OTHER	AL	COMMERCIALS USE TAX ID

General Provider Information

NPI Number	:	1972547479
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHARLES J VEALE MD

Provider Business Mailing Address
First Line	:	2160 MOORES MILL RD
Second Line	:
City	:	AUBURN
State	:	AL
Zip	:	36830-8447
Country	:	US
Telephone Number	:	334-826-1704
Fax Number	:	334-826-1787

Provider Business Practice Location Address
First Line	:	2160 MOORES MILL RD
Second Line	:
City	:	AUBURN
State	:	AL
Zip	:	36830-8447
Country	:	US
Telephone Number	:	334-826-1704
Fax Number	:	334-826-1787

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/15/2006
Last Update Date	:	08/31/2011

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Directions to “ DR. CHARLES J VEALE MD” Practice Location

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