Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. CHARLES E. MCCULLOUGH, CPT
Active2251H1200X · BROOKINGS, SD
Registration Details
- NPI Number
- 1265484216
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- May 17, 2006 (19.950593340169 yrs)
- Last Updated
- Mar 20, 2020
- Licenses
-
0560 (SD)0560 (SD)
Practice Information
- Address
-
400 22ND AVE.BROOKINGS, SD, 570062497Browse SD providers · Browse ZIP 57006
- Phone
- 6056979500
- Fax
- 6056976939
- Primary Specialty
-
2251H1200X
2251H1200X
- Additional Specialty
- 2251H1200X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.