Provider Demographics
NPI:1184680027
Name:RULA, CHARLES ARTHUR (MD)
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:ARTHUR
Last Name:RULA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO 220
Mailing Address - Street 2:25892 N. JAMES MADISON HWY
Mailing Address - City:NEW CANTON
Mailing Address - State:VA
Mailing Address - Zip Code:23123-0220
Mailing Address - Country:US
Mailing Address - Phone:434-581-3271
Mailing Address - Fax:434-581-1105
Practice Address - Street 1:25892 N JAMES MADISON HWY
Practice Address - Street 2:
Practice Address - City:NEW CANTON
Practice Address - State:VA
Practice Address - Zip Code:23123-2234
Practice Address - Country:US
Practice Address - Phone:434-581-3271
Practice Address - Fax:434-581-1105
Is Sole Proprietor?:No
Enumeration Date:2006-04-20
Last Update Date:2015-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101025367207P00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010243C95 - C03895Medicare PIN
VAB05893Medicare UPIN
VA002768P95Medicare PIN