Individual
DR. CHARLES A CRECELIUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10 BARNES WEST DR, DIV IM GERIATRICS, STE 200, SAINT LOUIS, MO 63141-6287
(314) 273-4374
(314) 983-0155
Mailing address
PO BOX 7412011, CHICAGO, IL 60674-2011
(314) 273-4374
(314) 983-0155
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
R7F42
MO
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
R7F42
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
202434734
—
MO
Enumeration date
01/19/2007
Last updated
04/17/2025
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