# CHARLES DOUGLAS PIERSOL

> 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:** No

## Provider details

- **NPI number:** 1558375352
- **Gender:** Man
- **Credential:** DC DACRB

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | 479 | WV | — |
| 111N00000X | Chiropractor | DC1372 | OH | Yes |
| 111NR0400X | Rehabilitation Chiropractor | 1372 | OH | — |

## Other

- **Enumeration date:** 07/28/2006
- **Last updated:** 10/05/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000000153108 | ANTHEM | — |
| 01 | — | 000000153109 | ANTHEM | — |
| 01 | — | 000000191919 | UNITED HEALTH CARE MEDICAID | OH |
| 01 | — | 000194827 | MOUNTAIN STATE BCBS | — |
| 01 | — | 0131222000 | UNISYS | WV |
| 05 | — | 0690766 | — | OH |
| 01 | — | 23288676004 | MEDICAL MUTUAL | — |
| 01 | — | 4352320 | AETNA | — |
| 01 | — | 55067803701 | WV WORKERS COMP | — |
| 01 | — | W01372A | HEALTH PLAN | — |