Charles, Thomas B.

Charles, Thomas B. is an individual health care provider with primary practice located at 12266 Depaul Dr. Suite 305, Bridgeton MO 63044-2516. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Charles, Thomas B. can be contacted via phone (314) 770-0991.

Contact Information

Primary practice address
12266 Depaul Dr. Suite 305 Bridgeton MO 63044-2516
Phone: (314) 770-0991
Fax: (314) 770-0692
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 100363 Missouri

Profile Details

NPI number 1629012042
LBN Legal business name Charles, Thomas B.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 15th, 2006
Last updated Nov 3rd, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1629012042 NPPES
Missouri MEDICAID 203411509
Missouri Other 770000196
Missouri Other L90344
Missouri Other L90347

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