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General NPI Number Information
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NPI Number | 1447407069
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Entity Type | Organization
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Legal Business Name | PADMINI CHARLES MD PC
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Dates
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Enumeration Date | 08/26/2008
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Last Update Date | 01/26/2010
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Provider Practice Location Address
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Address Line | 1400 HIGHWAY 61 JMH MOC G40
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City | FESTUS
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State | MO
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Zip | 63028-4100
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Country | US
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Telephone | 636-937-8989
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Fax | 636-933-2962
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Provider Business Mailing Address
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Address Line | 1400 HWY 61 SOUTH G60 JMH MOC SOUTH
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City | FESTUS
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State | MO
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Zip | 63028-4143
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Country | US
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Telephone | 636-937-8989
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. PADMINI CHARLES
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Credential | M.D., P.C.
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Telephone | 636-937-8989
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | R6353
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License Number State | MO
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