Provider Demographics
NPI:1942059654
Name:REZABEK, CHARLES JEFFREY (DO)
Entity type:Individual
Prefix:
First Name:CHARLES
Middle Name:JEFFREY
Last Name:REZABEK
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:CHARLIE
Other - Middle Name:JEFFREY
Other - Last Name:REZABEK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:502 E MONROE ST
Mailing Address - Street 2:
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57701-1400
Mailing Address - Country:US
Mailing Address - Phone:605-755-6040
Mailing Address - Fax:605-755-4012
Practice Address - Street 1:502 E MONROE ST
Practice Address - Street 2:
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57701-1400
Practice Address - Country:US
Practice Address - Phone:605-755-4060
Practice Address - Fax:605-755-4012
Is Sole Proprietor?:No
Enumeration Date:2024-05-15
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program