Provider Demographics
NPI:1245223320
Name:BELL, CHARLES HERBERT (DO)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:HERBERT
Last Name:BELL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 29834
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85038-9834
Mailing Address - Country:US
Mailing Address - Phone:602-553-8400
Mailing Address - Fax:602-553-8408
Practice Address - Street 1:2020 N CENTRAL AVE
Practice Address - Street 2:STE 1010
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85004-4501
Practice Address - Country:US
Practice Address - Phone:602-553-8400
Practice Address - Fax:602-553-8408
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ2234207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZE41844Medicare UPIN
AZ70045Medicare ID - Type Unspecified
AZ293457-06Medicare ID - Type Unspecified