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:
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Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1780639500 NPPES
Colorado Other 44477 STATE LICENSE
Colorado MEDICAID 18603271 STATE LICENSE

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