Candace Donyusha Charles, PA

NPI #1922284504 in O Fallon, Illinois

Provider Information

NPI Number: 1922284504
Entity Type: Individual
Name: Candace Donyusha Charles, PA
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA
Enumeration Date: Jan 14, 2008
Last Updated: Aug 2, 2018

Practice Location

Address: 4965 STONE FALLS CTR STE 7
City: O Fallon
State: Illinois
ZIP Code: 62269-7803
Phone: (618) 726-2500

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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