Individual
CHARLES A BLOTNICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2015 RANDOLPH RD, SUITE 108, CHARLOTTE, NC 28207-1200
(704) 334-2020
(704) 334-6175
Mailing address
1615 HUGH FOREST RD, CHARLOTTE, NC 28270-3446
(704) 334-2020
(704) 334-6175
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
21278
SC
207W00000X
Ophthalmology Physician
Primary
9901116
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
212781
—
SC
05
—
891229K
—
NC
Enumeration date
03/16/2006
Last updated
01/03/2013
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