Individual
CHARLES R MEAD
Active
Individual
CHARLES R MEAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
LD1642000
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
107964
UCARE MN
MN
01
—
110992
PATIENT CHOICE
MN
05
—
123023900
—
MN
01
—
21-15729
MEDICA MATERIALS
MN
01
—
2202721
MEDICA
MN
01
—
25841ME
BLUE CROSS BLUE SHIELD
MN
01
—
410038747
RAILROAD MEDICARE
MN
01
—
580610207
MEDICARE ID
MN
01
—
622001
PREFERRED ONE
MN
Enumeration date
07/20/2006
Last updated
02/23/2016
Update your record
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