Provider Demographics
NPI:1578797577
Name:SINGLETON, CHARLES MCENTEE II (MD)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:MCENTEE
Last Name:SINGLETON
Suffix:II
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4423 W 70TH TER
Mailing Address - Street 2:
Mailing Address - City:PRAIRIE VILLAGE
Mailing Address - State:KS
Mailing Address - Zip Code:66208-2563
Mailing Address - Country:US
Mailing Address - Phone:913-722-5666
Mailing Address - Fax:
Practice Address - Street 1:4423 W 70TH TER
Practice Address - Street 2:
Practice Address - City:PRAIRIE VILLAGE
Practice Address - State:KS
Practice Address - Zip Code:66208-2563
Practice Address - Country:US
Practice Address - Phone:913-722-5666
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-06
Last Update Date:2009-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO28550207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO00001683Medicare UPIN