Individual
DR. DON CHARLES WUKASCH
Active
Individual
DR. DON CHARLES WUKASCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.,FACS,FACC,FACCP
Taxonomy
Speciality
Code
Description
License number
State
103TP0814X
Psychoanalysis Psychologist
D0356
TX
2084P0800X
Psychiatry Physician
Primary
D0356
TX
208600000X
Surgery Physician
D0356
TX
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
D0356
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
231167
MEDICAL STATE LICENSE NUMBER
MA
01
—
D 0356
MEDICAL LICENSE NUMBER
TX
01
—
K0016291
CON TROLLED SUBSTANCE REGISTRATION
TX
01
—
MW0858766A
CON TROLLED SUBSTANCE REGISTRATION
MA
Enumeration date
01/05/2007
Last updated
04/16/2012
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