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Contact Information

CHARLES A WETHERINGTON, MD
1055 BOWLES AVE STE 200
FENTON, MO63026-2308
 Phone: 636-496-3900
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Neurological Surgery

207T00000X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for CHARLES A WETHERINGTON · (Male)

NPI Number 1326048935
Status Active
Credentials MD
Entity Individual
Enumeration date 07/26/2005
Last updated 11/24/2020 - About 6 years ago
Sole proprietor 1 Yes
Identifiers
  • MO License # 104062
  • MO Medicaid 204694509
Hospital affiliation(s)
  • SSM ST CLARE HEALTH CENTER - (Acute Care)
    1015 BOWLES
    FENTON, MO 63026
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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