Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0106X | Orthopaedic Hand Surgeon | 18891 | MS |
NPI | 1255360186 |
---|---|
Provider Name | Dr. Constantine P Charoglu |
First Address | Hattiesburg, MS 39401-8246 |
Second Address | Hattiesburg, MS 39401-8246 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/07/2006 |
Last Update Date | 23/12/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
05431595 | (05) | MS |
H41077 | (02) | MS |