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Individual

CHARLTON A PETER

Active
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Individual

CHARLTON A PETER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DPM

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
DPM303
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0490250001
NSC PALMETTO GBA REG C
05
3351297
TN
01
66264
BLUE CROSS BLUE SHIELD
TN
Enumeration date
10/20/2006
Last updated
02/12/2008
About Stedi
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