Individual
DR. CHARLES ALAN TRACY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
40 MEDICAL PARK, SUITE 200, WHEELING, WV 26003-6392
(304) 242-0590
(304) 242-9740
Mailing address
40 MEDICAL PARK, SUITE 200, WHEELING, WV 26003-6392
(304) 242-0590
(304) 242-9740
Taxonomy
Speciality
Code
Description
License number
State
2086S0105X
Surgery of the Hand (Surgery) Physician
14893
WV
2086S0105X
Surgery of the Hand (Surgery) Physician
35054828
OH
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
14893
WV
2086S0122X
Plastic and Reconstructive Surgery Physician
35054828
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0114127000
—
WV
05
—
0859085
—
OH
01
—
14893
HMO
—
Enumeration date
09/20/2005
Last updated
04/14/2008
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