Provider Demographics
NPI:1902244965
Name:BENGTSON, CHARLES DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:DAVID
Last Name:BENGTSON
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Gender:M
Credentials:MD
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Mailing Address - Street 1:3901 RAINBOW BLVD # MS 3007
Mailing Address - Street 2:KUMC PULMONARY CRITICAL CARE FELLOWSHIP PROGRAM
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66160-0001
Mailing Address - Country:US
Mailing Address - Phone:913-588-6046
Mailing Address - Fax:913-588-4098
Practice Address - Street 1:3901 RAINBOW BLVD # MS 2027
Practice Address - Street 2:KUMC PULMONARY CRITICAL CARE FELLOWSHIP PROGRAM
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66160-0001
Practice Address - Country:US
Practice Address - Phone:913-588-3974
Practice Address - Fax:913-588-0593
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-11
Last Update Date:2016-07-21
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Provider Licenses
StateLicense IDTaxonomies
KS9408190207R00000X
KS04-39016207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine