Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | 2019-01218 | NC |
N | 207T00000X | Neurosurgeon | 35.122041 | OH |
N | 207T00000X | Neurosurgeon | MD451261 | PA |
NPI | 1033308564 |
---|---|
Provider Name | Dr. Charles Nelson Munyon |
First Address | Philadelphia, PA 19129-1302 |
Second Address | Charlotte, NC 28211-5020 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/10/2007 |
Last Update Date | 26/10/2020 |