Individual
DR. CHARLES ROBERT BLACKWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
200 SE HOSPITAL AVE, STUART, FL 34994-2346
(772) 287-5299
Mailing address
5395 LONDON GROVEPORT RD, ORIENT, OH 43146-9220
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
125074845
IL
208D00000X
General Practice Physician
OS017238
PA
Other
Enumeration date
06/04/2013
Last updated
06/08/2022
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