# DR. CHARLES S. HARRIMAN

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1033221353
- **Gender:** Man
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 101451 | MO | Yes |

## Other

- **Enumeration date:** 08/31/2006
- **Last updated:** 10/28/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 126882 | BLUE CROSS MO | — |
| 05 | — | 204890800 | — | MO |
| 01 | — | 431560263 | TRICARE WEST | — |