MEDICARE: MICHAEL S CHARLES MD

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	208600000X	Surgery Physician	H5534	TX
2	2086S0102X	Surgical Critical Care Physician	28445	OK

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	:	1942293097
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL S CHARLES MD

Provider Business Mailing Address
First Line	:	1919 S WHEELING AVE
Second Line	:	STE 606
City	:	TULSA
State	:	OK
Zip	:	74104-5635
Country	:	US
Telephone Number	:	918-748-7676
Fax Number	:

Provider Business Practice Location Address
First Line	:	1919 S WHEELING AVE
Second Line	:	STE 606
City	:	TULSA
State	:	OK
Zip	:	74104-5635
Country	:	US
Telephone Number	:	918-748-7676
Fax Number	:

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

Provider Enumeration Date	:	08/24/2005
Last Update Date	:	11/10/2017

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Directions to “ MICHAEL S CHARLES MD” Practice Location

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