# CHARLES RICHARD BLAKE

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1386645224
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | 29828 | SC | — |
| 207W00000X | Ophthalmology Physician | ME90057 | FL | Yes |

## Other

- **Enumeration date:** 08/02/2005
- **Last updated:** 06/01/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 010129300 | — | FL |
| 01 | — | 0800815 | UNITED HEALTHCARE | NC |
| 01 | — | 141A6 | BCBS NC | NC |
| 01 | — | 183075 | MEDCOST | NC |
| 01 | — | 32840 | OPTICARE | NC |
| 05 | — | 5902230 | — | NC |
| 01 | — | 7273542 | AETNA | NC |
| 01 | — | 806940 | COMMUNITY EYE CARE | NC |
| 05 | — | GP4696 | — | SC |
| 01 | — | OPH174 | PRIMAHEALTH | NC |