Individual
DR. CHARLES S. HARRIMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
608 CITY BUSINESS ROUTE 66, SAINT ROBERT, MO 65584-0974
(553) 336-5100
(573) 336-3118
Mailing address
608 CITY ROUTE 66, SAINT ROBERT, MO 65584-0974
(573) 336-5100
(573) 336-3118
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
101451
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
126882
BLUE CROSS MO
—
05
—
204890800
—
MO
01
—
431560263
TRICARE WEST
—
Enumeration date
08/31/2006
Last updated
10/28/2008
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