Individual
PIERRE S CHARLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1025 MAINE ST, QUINCY, IL 62301-4038
(217) 222-6550
Mailing address
1025 MAINE ST, QUINCY, IL 62301-4038
(217) 222-6550
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
036-119853
IL
208600000X
Surgery Physician
37422020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11205
DEAN HEALTH PLAN HMO
—
05
—
1457369480
—
WI
Enumeration date
08/04/2006
Last updated
11/07/2016
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