Individual
CHARLES RICHARD GULICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9450 MANCHESTER RD, SAINT LOUIS, MO 63119-1452
(314) 725-9300
(314) 725-4662
Mailing address
670 MASON RIDGE CENTER DR, STE 300, SAINT LOUIS, MO 63141-8573
(314) 725-9300
(314) 725-4662
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
34749
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
161803838
RAILROAD MEDICARE
—
01
—
4122
BCBS
—
Enumeration date
11/14/2006
Last updated
02/20/2012
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