Provider Demographics
NPI:1477556405
Name:LINSENMEYER, CHARLES M (MD)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:M
Last Name:LINSENMEYER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:9323 PHOENIX VILLAGE PKWY
Mailing Address - Street 2:
Mailing Address - City:O FALLON
Mailing Address - State:MO
Mailing Address - Zip Code:63366-4281
Mailing Address - Country:US
Mailing Address - Phone:636-561-5030
Mailing Address - Fax:636-561-5033
Practice Address - Street 1:400 1ST CAPITOL DR
Practice Address - Street 2:STE 100
Practice Address - City:SAINT CHARLES
Practice Address - State:MO
Practice Address - Zip Code:63301-2881
Practice Address - Country:US
Practice Address - Phone:636-946-7050
Practice Address - Fax:636-946-3368
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-05-23
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MOR2608207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
4435V6097OtherHEALTHCARE USA
900095OtherUHC
SP10136OtherCIGNA
4061155OtherAETNA
MO27610OtherBLUE CROSS BLUE SHIELD
42206OtherCMR
9041OtherEXCLUSIVE CHOICE
114559OtherHEALTHLINK
1161V3458OtherGHP/ADVANTRA
SP10136OtherCIGNA