Individual
CHARLES EDWARD LANDIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
851 E 5TH ST, WASHINGTON, MO 63090-3135
(636) 390-8555
(636) 390-9444
Mailing address
851 E 5TH ST STE 300, WASHINGTON, MO 63090-3130
(636) 390-8555
(636) 390-9444
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
2022013547
MO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/22/2019
Last updated
07/21/2022
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