Provider Demographics
NPI:1053360040
Name:NIGHTINGALE, CHARLES HOOSHMAND (MD)
Entity type:Individual
Prefix:
First Name:CHARLES
Middle Name:HOOSHMAND
Last Name:NIGHTINGALE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4677 TOWNE CENTRE RD
Mailing Address - Street 2:SUITE 302
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48604-2846
Mailing Address - Country:US
Mailing Address - Phone:989-793-7220
Mailing Address - Fax:989-793-7482
Practice Address - Street 1:800 S WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48601-2551
Practice Address - Country:US
Practice Address - Phone:989-907-8200
Practice Address - Fax:989-907-8294
Is Sole Proprietor?:No
Enumeration Date:2006-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA057906207PE0004X
MI4301081769207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
Not Answered207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine