Provider Demographics
NPI:1871596809
Name:EPES, CHARLES RICHARD (MD)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:RICHARD
Last Name:EPES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 38157
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27438-8157
Mailing Address - Country:US
Mailing Address - Phone:336-282-5000
Mailing Address - Fax:336-482-3778
Practice Address - Street 1:3312 BATTLEGROUND AVE
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27410-2402
Practice Address - Country:US
Practice Address - Phone:336-282-5000
Practice Address - Fax:336-482-3778
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2010-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC17246207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC180028993OtherRR MEDICARE PROVIDER #
NC10203OtherOPTICARE PROVIDER #
NC4098420OtherAETNA PROVIDER #
NC30685OtherBCBS PROVIDER #
VA006356273OtherVA MEDICAID PROVIDER #
VA035007OtherANTHEM BCBS PROVIDER #
NC278838OtherMAMSI PROVIDER #
NC61272OtherMEDCOST PROVIDER #
NC740OtherPARTNERS PROVIDER #
NC8930685Medicaid
NC10203OtherOPTICARE PROVIDER #
NC740OtherPARTNERS PROVIDER #
NC278838OtherMAMSI PROVIDER #