Provider Demographics
NPI:1770573701
Name:LERNER, CHARLES J (MD)
Entity type:Individual
Prefix:
First Name:CHARLES
Middle Name:J
Last Name:LERNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:12721 HUNTERS CHASE
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78230-1929
Mailing Address - Country:US
Mailing Address - Phone:210-861-0980
Mailing Address - Fax:210-492-8724
Practice Address - Street 1:12721 HUNTERS CHASE
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78230-1929
Practice Address - Country:US
Practice Address - Phone:210-861-0980
Practice Address - Fax:210-492-8724
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-21
Last Update Date:2010-08-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXD7434207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX134128107Medicaid
B24350Medicare UPIN
TX134128107Medicaid