Staley, Charles Augustin
Staley, Charles Augustin is an individual health care provider with primary practice located at 1365 Clifton Rd Ne Bldg C, Atlanta GA 30322-1013. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgical Oncology, which is considered as his primary health care specialty. Staley, Charles Augustin can be contacted via phone (404) 778-3301.Contact Information
Primary practice address
1365 Clifton Rd Ne Bldg C
Atlanta GA 30322-1013
Phone: (404) 778-3301
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgical Oncology | 2086X0206X | 040559 | Georgia |
Profile Details
| NPI number | 1134132657 |
|---|---|
| LBN Legal business name | Staley, Charles Augustin |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 14th, 2006 |
| Last updated | Sep 6th, 2011 - about 13 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1134132657 | NPPES |
| Georgia | Other | 542386 | BCBS |
| Georgia | Other | 1299416 | BCBS |
| Georgia | MEDICAID | 000664331A | BCBS |
| Georgia | Other | 581116 | BCBS |
| Georgia | Other | 910000107 | BCBS |
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