MEDICARE: CHRISTOPHER S ST. CHARLES M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Y00000X	Otolaryngology Physician	MD23591	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1669416855
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTOPHER S ST. CHARLES M.D.

Provider Business Mailing Address
First Line	:	106 SIGNAL POINT TRL
Second Line	:
City	:	SIGNAL MOUNTAIN
State	:	TN
Zip	:	37377-1839
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	106 SIGNAL POINT TRL
Second Line	:
City	:	SIGNAL MOUNTAIN
State	:	TN
Zip	:	37377-1839
Country	:	US
Telephone Number	:	--
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/16/2006
Last Update Date	:	01/09/2025

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