Individual
CHARLES M BLANTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1401 MATTHEWS TOWNSHIP PKWY, SUITE 100, MATTHEWS, NC 28105-5402
(704) 384-1080
(704) 384-1122
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 384-1080
(704) 384-1122
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
95-00513
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8916237
—
NC
05
—
N00516
—
SC
Enumeration date
02/02/2006
Last updated
10/28/2020
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