Provider Demographics
NPI:1366581852
Name:SEKHON, CHARLOTTE (DPM)
Entity type:Individual
Prefix:
First Name:CHARLOTTE
Middle Name:
Last Name:SEKHON
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:CHARLOTTE
Other - Middle Name:
Other - Last Name:LORESTANI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPM
Mailing Address - Street 1:1050 W 10TH ST
Mailing Address - Street 2:
Mailing Address - City:ROLLA
Mailing Address - State:MO
Mailing Address - Zip Code:65401-2905
Mailing Address - Country:US
Mailing Address - Phone:573-426-6239
Mailing Address - Fax:573-426-6247
Practice Address - Street 1:1050 W 10TH ST
Practice Address - Street 2:
Practice Address - City:ROLLA
Practice Address - State:MO
Practice Address - Zip Code:65401-2905
Practice Address - Country:US
Practice Address - Phone:573-426-6239
Practice Address - Fax:573-426-6247
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2010-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0103300967213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery