Individual
DR. CHARLES S EBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4921 PARKVIEW PL, DIV PA LAB AND GENOMIC MED, STE 4E, SAINT LOUIS, MO 63110-1032
(314) 362-5641
(314) 362-0369
Mailing address
PO BOX 7412011, CHICAGO, IL 60674-2011
(314) 362-5641
(314) 362-0369
Taxonomy
Speciality
Code
Description
License number
State
207ZB0001X
Blood Banking & Transfusion Medicine Physician
Primary
R6J04
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
203006531
—
MO
Enumeration date
07/14/2006
Last updated
04/17/2025
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