Individual
CHARLES ROBERT HARTMAN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
300 MEDICAL PLZ STE 310, LAKE ST LOUIS, MO 63367-1484
(636) 625-2662
Mailing address
10890 VETERANS MEMORIAL PARKWAY, LAKE ST LOUIS, MO 63367-1475
(636) 561-6801
(636) 625-1601
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
R5P00
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
248492001
—
MO
Enumeration date
11/25/2005
Last updated
11/04/2020
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