Individual
DR. CHARLES MAURICE KANTROW JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9422 SCOTLAND AVE, BATON ROUGE, LA 70807-3951
(225) 774-1822
(225) 774-1836
Mailing address
9422 SCOTLAND AVE, BATON ROUGE, LA 70807-3951
(225) 774-1822
(225) 774-1836
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
009101
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1117692
—
LA
Enumeration date
05/11/2006
Last updated
10/31/2007
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