Individual
CHARLES M WALBAUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
611 W MAIN ST, FREDERICKTOWN, MO 63645-1111
(573) 783-3341
(573) 783-1096
Mailing address
611 W MAIN ST, FREDERICKTOWN, MO 63645-1111
(573) 783-3341
(573) 783-1096
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
056545
MO
Other
Enumeration date
12/18/2006
Last updated
02/27/2009
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