Provider Demographics
NPI:1194288779
Name:CHARLES, DOROTHY N (MD)
Entity type:Individual
Prefix:DR
First Name:DOROTHY
Middle Name:N
Last Name:CHARLES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3396 PERSHALL RD
Mailing Address - Street 2:
Mailing Address - City:FERGUSON
Mailing Address - State:MO
Mailing Address - Zip Code:63135-1407
Mailing Address - Country:US
Mailing Address - Phone:314-814-8700
Mailing Address - Fax:314-814-8589
Practice Address - Street 1:3396 PERSHALL RD
Practice Address - Street 2:
Practice Address - City:FERGUSON
Practice Address - State:MO
Practice Address - Zip Code:63135-1407
Practice Address - Country:US
Practice Address - Phone:314-814-8700
Practice Address - Fax:314-814-8589
Is Sole Proprietor?:No
Enumeration Date:2019-04-10
Last Update Date:2025-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2025032016207Q00000X
IL036161491207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine