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Individual

CHARLES S PEWITT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
2387 W JACKSON BLVD, JACKSON, MO 63755-3018
(573) 243-9288
(573) 204-7074
Mailing address
2387 W JACKSON BLVD, JACKSON, MO 63755-3018
(573) 243-9288
(573) 204-7074

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
R9F48
MO

Other

Enumeration date
09/22/2006
Last updated
07/08/2007
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