Provider Demographics
NPI:1871332072
Name:STAUTNER, CHARLES JOSEPH ERNST (MD, MBA)
Entity type:Individual
Prefix:DR
First Name:CHARLES JOSEPH
Middle Name:ERNST
Last Name:STAUTNER
Suffix:
Gender:M
Credentials:MD, MBA
Other - Prefix:DR
Other - First Name:CHARLESJOSEPH
Other - Middle Name:ERNST
Other - Last Name:STAUTNER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD, MBA
Mailing Address - Street 1:1514 JEFFERSON HWY
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70121-2483
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1514 JEFFERSON HWY
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70121-2483
Practice Address - Country:US
Practice Address - Phone:504-842-4796
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-20
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program