Individual
DR. CHARLES DAVID ETTELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
730 AUDUBON DR, SAINT LOUIS, MO 63105-2906
(314) 324-7605
Mailing address
730 AUDUBON DR, SAINT LOUIS, MO 63105-2906
(314) 324-7605
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
R9446
MO
Other
Enumeration date
08/03/2005
Last updated
07/02/2013
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