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Individual
DR. CHARLES C YOUNG
Active
Individual
DR. CHARLES C YOUNG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5353A
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080086864
PALMETTO
WY
05
—
109204900
—
WY
01
—
307083
BLUE CROSS BLUE SHIELD
WY
01
—
344550
COMBINED INSURANCE
WY
01
—
490301955
LAB CORP
WY
01
—
5353A
LICENSE
WY
01
—
53D0909290
CLIA
WY
01
—
563365
WY WORKERS COMPENSATION
WY
01
—
850335622
TAX ID
WY
Enumeration date
10/02/2006
Last updated
03/07/2023
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