Individual
CHARL STANHOPE VAN WYK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
800 ROSE ST, HX311, LEXINGTON, KY 40536-2379
(859) 323-5069
Mailing address
800 ROSE ST, HX311, LEXINGTON, KY 40536-2379
(859) 323-5069
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
39288
KY
2085R0202X
Diagnostic Radiology Physician
Primary
39288
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2591039
—
OH
05
—
3810002596
—
WV
05
—
64092455
—
KY
Enumeration date
06/02/2006
Last updated
06/22/2015
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