Provider Demographics
NPI:1689632820
Name:TONEY, CHARLES M (CRNA)
Entity type:Individual
Prefix:
First Name:CHARLES
Middle Name:M
Last Name:TONEY
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:CHARLES
Other - Middle Name:M
Other - Last Name:TONEY,CRNA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CRNA
Mailing Address - Street 1:2286 ARMAND RD NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30324-4200
Mailing Address - Country:US
Mailing Address - Phone:404-842-1888
Mailing Address - Fax:
Practice Address - Street 1:2286 ARMAND RD NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30324-4200
Practice Address - Country:US
Practice Address - Phone:404-842-1888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-03
Last Update Date:2007-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN074101367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA52759904-006OtherBLUE CROSS BLUE SHIELD