# DR. CHARLES C YOUNG

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1538252077
- **Gender:** Man
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 5353A | WY | Yes |

## Other

- **Enumeration date:** 10/02/2006
- **Last updated:** 03/07/2023

## 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 |