Individual
CHARLES C INGRAM
Active
Individual
CHARLES C INGRAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
30064
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00120711
—
MS
05
—
140245001
—
AR
05
—
205095300
—
MO
01
—
3091897
BLUECROSS BLUESHIELD
TN
05
—
3825084
—
TN
01
—
50065532
MEDICARE RAILROAD
—
01
—
97920
BLUECROSS BLUESHIELD
AR
Enumeration date
05/22/2006
Last updated
01/24/2025
Update your record
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