Individual
DR. CHARLES ROBERT NATHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
845 N NEW BALLAS CT, SUITE 300, SAINT LOUIS, MO 63141-7134
(314) 569-0130
(314) 569-3674
Mailing address
17300 N. OUTER 40 RD, SUITE 300, CHESTERFIELD, MO 63005
(636) 530-6161
(636) 777-7500
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
MD110027
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
240007092
RR MEDICARE
MO
Enumeration date
03/03/2008
Last updated
02/18/2015
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