Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 62947-20 | WI |
Y | 207VX0201X | Gynecologic Oncologist | 042-0015492 | VT |
NPI | 1205179660 |
---|---|
Provider Name | Charles Warner Ashley |
First Address | Madison, WI 53792-0001 |
Second Address | Burlington, VT 05401-1473 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/04/2013 |
Last Update Date | 16/09/2021 |