Charles R Green, PA-C

NPI #1962574285 in Petoskey, Michigan

Provider Information

NPI Number: 1962574285
Entity Type: Individual
Name: Charles R Green, PA-C
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA-C
Enumeration Date: Nov 14, 2006
Last Updated: Jan 5, 2009

Practice Location

Address: 1937 M 119
City: Petoskey
State: Michigan
ZIP Code: 49770-8913
Phone: (231) 348-9200

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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