Healthcare Provider Details

I. General information

NPI: 1073540431
Provider Name (Legal Business Name): CHARLES E AUER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/28/2006
Last Update Date: 05/10/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 HEALTH CARE DR
GREENVILLE IL
62246-1154
US

IV. Provider business mailing address

2100 POWELL ST SUITE 900
EMERYVILLE CA
94608-1826
US

V. Phone/Fax

Practice location:
  • Phone: 618-664-1230
  • Fax:
Mailing address:
  • Phone: 510-350-2664
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number036-084924
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number036-084924
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: