Individual
CHARLES E SHEARER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
517 LINCOLNWAY E, MISHAWAKA, IN 46544-2211
(574) 255-6363
(574) 255-4182
Mailing address
517 LINCOLNWAY E, MISHAWAKA, IN 46544-2211
(574) 255-6363
(574) 255-4182
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18001872
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000084194
BLUE CROSS BLUE SHIELD
IN
05
—
100222260A
—
IN
01
—
1659454916
NPI
IN
Enumeration date
10/23/2006
Last updated
04/28/2011
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