Individual
MR. CHARLES WESLEY LALLIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4022 FREEDOM LAKE DR, DURHAM, NC 27704
(919) 477-2202
(919) 471-2270
Mailing address
4022 FREEDOM LAKE DR, DURHAM, NC 27704
(919) 477-2202
(919) 471-2270
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
28057
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1250106
UNITED HEALTHCARE
—
01
—
269611
MAMSI ALLIANCE
—
01
—
4221816
AETNA
—
01
—
50121
MEDCOST
—
01
—
50624
BSBC STATE FEDERAL NC HEA
NC
01
—
8950624
CAROLINA ACCESS NC
—
05
—
8950624
—
NC
Enumeration date
04/19/2006
Last updated
01/27/2011
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