Individual
CHARLES AUGUSTIN STALEY
Active
Individual
CHARLES AUGUSTIN STALEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2086X0206X
Surgical Oncology Physician
Primary
040559
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000664331A
—
GA
01
—
1299416
UNITED HEALTHCARE
GA
01
—
542386
BCBS
GA
01
—
581116
US HEALTHCARE
GA
01
—
910000107
RAILROAD MEDICARE
GA
Enumeration date
08/14/2006
Last updated
09/06/2011
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