Charles David Ettelson, M.D.
NPI 1255332904ActiveIndividual· Surgery, Plastic and Reconstructive Surgery· Saint Louis, MO
Surgery, Plastic and Reconstructive Surgery (M.D.) in Saint Louis, Missouri, licensed in MO, with an NPI issued in August 2005.
Overview
| NPI | 1255332904 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | M.D. |
| Sole proprietor | Yes |
| NPI issued | Aug 3, 2005 |
| Last updated in NPPES | Jul 2, 2013 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Surgery, Plastic and Reconstructive Surgery Primary | 2086S0122X | R9446 | MO |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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