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Individual

MICHAEL S CHARLES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1919 S WHEELING AVE, STE 606, TULSA, OK 74104-5635
(918) 748-7676
Mailing address
1919 S WHEELING AVE, STE 606, TULSA, OK 74104-5635
(918) 748-7676

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
H5534
TX
2086S0102X
Surgical Critical Care Physician
Primary
28445
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
123647301
TX
Enumeration date
08/24/2005
Last updated
11/10/2017
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