# CHARLES DANIEL PROCTER SR.

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

## Provider details

- **NPI number:** 1457369258
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2086S0129X | Vascular Surgery Physician | 035736 | GA | Yes |

## Other

- **Enumeration date:** 08/04/2006
- **Last updated:** 03/31/2025

## 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 |