Individual
DR. CHARLES WAYNE GATES
Active
Individual
DR. CHARLES WAYNE GATES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
Primary
0101037916
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006503403
—
VA
01
—
462160
ANTHEM PROVIDER ID NUMBER
VA
Enumeration date
08/24/2005
Last updated
11/03/2011
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