Provider Demographics
NPI:1861022873
Name:CHUCK R. COLAS, D.O., P.C.
Entity Type:Organization
Organization Name:CHUCK R. COLAS, D.O., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:MARY
Authorized Official - Last Name:BERCHELMANN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:314-435-6105
Mailing Address - Street 1:711 SILVERMINE RD
Mailing Address - Street 2:
Mailing Address - City:NEW CANAAN
Mailing Address - State:CT
Mailing Address - Zip Code:06840-4329
Mailing Address - Country:US
Mailing Address - Phone:314-888-5233
Mailing Address - Fax:203-590-8644
Practice Address - Street 1:#66, COUNTY RD. 37 #6
Practice Address - Street 2:
Practice Address - City:CEDARVILLE
Practice Address - State:CA
Practice Address - Zip Code:96104
Practice Address - Country:US
Practice Address - Phone:314-888-5233
Practice Address - Fax:203-590-8644
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-17
Last Update Date:2020-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty