Individual
DR. CHARLES M LEDERER JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
506 BURKARTH RD, A, WARRENSBURG, MO 64093-3104
(660) 747-2202
(660) 747-1223
Mailing address
2905 W 125TH ST, LEAWOOD, KS 66209-2427
(913) 327-1041
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
R8629
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09486042
BLUE CROSS BLUE SHIELD
MO
01
—
09486052
BLUE CROSS BLUE SHIELD
MO
Enumeration date
07/21/2006
Last updated
10/26/2007
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