Provider Demographics
NPI:1164664637
Name:ARENA, CHARLES M (MD)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:M
Last Name:ARENA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:6065 FASHION BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84107-7381
Mailing Address - Country:US
Mailing Address - Phone:801-268-1610
Mailing Address - Fax:801-268-1221
Practice Address - Street 1:6065 FASHION BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84107-7381
Practice Address - Country:US
Practice Address - Phone:801-268-1610
Practice Address - Fax:801-268-1221
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-30
Last Update Date:2009-03-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
UT171559-1205207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine