Individual
CHARLES WELCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
54 HOSPITAL DR, OSAGE BEACH, MO 65065-3050
(573) 302-1661
(573) 302-1719
Mailing address
PO BOX 840, OSAGE BEACH, MO 65065-0840
(573) 302-1661
(573) 302-1719
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
083022
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100246940B
—
KS
05
—
100787260A
—
OK
01
—
430027961
RR MEDICARE
—
05
—
912689502
—
MO
Enumeration date
06/03/2006
Last updated
02/10/2016
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