Individual
DR. CHARLES MAXWELL MEDERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
036.159124
IL
207W00000X
Ophthalmology Physician
Primary
U2087
TX
Other
Enumeration date
03/20/2017
Last updated
03/23/2023
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