Individual
DR. CHARLES CARTER GENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2142 N COVE BLVD, TOLEDO, OH 43606-3895
(419) 291-4438
(419) 479-6078
Mailing address
4841 MONROE ST, SUITE 103, TOLEDO, OH 43623-4385
(419) 474-4064
(419) 472-2772
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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