Provider Demographics
NPI:1659548279
Name:PIERCE, CHARLES ALAN (DO, MPH)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:ALAN
Last Name:PIERCE
Suffix:
Gender:M
Credentials:DO, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 BROAD ST
Mailing Address - Street 2:
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-2178
Mailing Address - Country:US
Mailing Address - Phone:732-852-2770
Mailing Address - Fax:
Practice Address - Street 1:333 BROAD ST
Practice Address - Street 2:
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701-2178
Practice Address - Country:US
Practice Address - Phone:901-448-1350
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-13
Last Update Date:2021-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY283468208200000X
NJ25MB09902000208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery