Individual
DR. CHARLES CARTER GENSON
Active
Individual
DR. CHARLES CARTER GENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
35-080240
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000393292
ANTHEM
—
05
—
2527091
—
OH
05
—
4908875
—
MI
05
—
4908884
—
MI
01
—
P00361698
TRICARE RR MEDICARE
—
Enumeration date
05/28/2006
Last updated
10/26/2007
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