Individual
MR. CHARLES MIGUEL SERRANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
6800 IL-162, MARYVILLE, IL 62062
(800) 281-3903
Mailing address
2621 SPYGLASS CT APT D, EDWARDSVILLE, IL 62025-3673
(435) 237-7040
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
041.494360
IL
Other
Enumeration date
05/05/2023
Last updated
05/05/2023
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