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Individual
CHARLES DANIEL PROCTER SR.
Active
Individual
CHARLES DANIEL PROCTER SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
035736
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000502873I
—
GA
05
—
000502873J
—
GA
05
—
000502873K
—
GA
05
—
000502873M
—
GA
05
—
000502873R
—
GA
05
—
000502873S
—
GA
05
—
000502873T
—
GA
01
—
01338970
AMERIGROUP
GA
01
—
1708262
WELLCARE
GA
01
—
544229
WELLCARE
GA
01
—
592947
BCBS
GA
Enumeration date
08/04/2006
Last updated
03/31/2025
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