Individual
CHARLES W MILLER III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10004 KENNERLY RD, #395-B, ST. LOUIS, MO 63128-2190
(314) 842-5660
(314) 842-0169
Mailing address
10004 KENNERLY RD, #395-B, ST. LOUIS, MO 63128-2190
(314) 842-5660
(314) 842-0169
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
34703
MO
Other
Enumeration date
05/22/2006
Last updated
08/18/2010
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