Brunson, Charlie Ed
Brunson, Charlie Ed is an individual health care provider with primary practice located at 4403 Harrison Blvd Ste 3490 , Ogden UT 84403-3284. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Cardiovascular Disease, Allopathic & Osteopathic Physicians / Interventional Cardiology. Allopathic & Osteopathic Physicians / Interventional Cardiology is his primary health care specialty. Brunson, Charlie Ed can be contacted via phone (801) 387-2650.Contact Information
Primary practice address
4403 Harrison Blvd Ste 3490
Ogden UT 84403-3284
Phone: (801) 387-2650
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | 44477 | Colorado |
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | 7752036-1205 | Utah |
| Allopathic & Osteopathic Physicians / Interventional Cardiology | 207RI0011X | 44477 | Colorado |
| Allopathic & Osteopathic Physicians / Interventional Cardiology | 207RI0011X | 7752036-1205 | Utah |
Profile Details
| NPI number | 1780639500 |
|---|---|
| LBN Legal business name | Brunson, Charlie Ed |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 23rd, 2006 |
| Last updated | Aug 17th, 2022 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1780639500 | NPPES |
| Colorado | Other | 44477 | STATE LICENSE |
| Colorado | MEDICAID | 18603271 | STATE LICENSE |
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