Provider Demographics
NPI:1073891131
Name:BROWN, CHARLES ASSUE (CCPC)
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:ASSUE
Last Name:BROWN
Suffix:
Gender:M
Credentials:CCPC
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:9330 MOORE RD
Mailing Address - Street 2:
Mailing Address - City:ZIONSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46077-9111
Mailing Address - Country:US
Mailing Address - Phone:317-583-5132
Mailing Address - Fax:317-583-7807
Practice Address - Street 1:8433 HARCOURT RD
Practice Address - Street 2:STE 100
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260-2190
Practice Address - Country:US
Practice Address - Phone:317-583-7600
Practice Address - Fax:317-583-7601
Is Sole Proprietor?:No
Enumeration Date:2011-07-23
Last Update Date:2011-07-23
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes242T00000XTechnologists, Technicians & Other Technical Service ProvidersPerfusionist