# CHARLES E. BARE II, M.D., P.A.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1790011906
- **Authorized official:** DR. CHARLES E BARE II M.D. (PRESIDENT)
- **Authorized official phone:** (913) 362-6781

## Contact information

- **Practice address:** 6909 SANTA FE DR, OVERLAND PARK, KS 66204-1357
- **Practice address phone:** (913) 362-6781
- **Practice address fax:** (913) 362-8646
- **Mailing address:** PO BOX 2407, MISSION, KS 66201-2407
- **Mailing address phone:** (913) 362-6781
- **Mailing address fax:** (913) 362-8646

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208800000X | Urology Physician | 0414404 | KS | Yes |

## Other

- **Enumeration date:** 10/22/2009
- **Last updated:** 03/10/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 620316 | BLUE CROSS BLUE SHIELD | KS |