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Individual

DR. CHARLES J SIEGEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
6000 N OAK TRFY, 102, GLADSTONE, MO 64118-5165
(816) 453-7771
(816) 452-7980
Mailing address
6000 N OAK TRFY, SUITE 102, GLADSTONE, MO 64118-5165
(816) 453-7771
(816) 452-7980

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
R9645
MO

Other

Enumeration date
05/02/2006
Last updated
11/13/2008
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