Mead, Charles R

Mead, Charles R is an sole proprietor health care provider with primary practice located at 1502 Woodlane Dr , Woodbury MN 55125-2221. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Mead, Charles R can be contacted via phone (651) 735-9550.

Contact Information

Primary practice address
1502 Woodlane Dr Woodbury MN 55125-2221
Fax: (651) 735-9322
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X LD1642000 Minnesota

Profile Details

NPI number 1932129905
LBN Legal business name Mead, Charles R
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 20th, 2006
Last updated Feb 23rd, 2016 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1932129905 NPPES
Minnesota MEDICAID 123023900
Minnesota Other 25841ME
Minnesota Other 2202721
Minnesota Other 110992
Minnesota Other 21-15729
Minnesota Other 107964
Minnesota Other 622001
Minnesota Other 410038747
Minnesota Other 580610207

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