Individual
CHARLES ORTWERTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
3015 N BALLAS RD, SAINT LOUIS, MO 63131-2329
(314) 996-5330
Mailing address
1836 LACKLAND HILL PKWY, ATTTN: CREDENTIALING, SAINT LOUIS, MO 63146-3572
(314) 989-0300
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
069381
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
430021986
RAILROAD MEDICARE
MO
05
—
912766714
—
MO
Enumeration date
05/04/2006
Last updated
12/08/2008
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