MRS. Charlene Carla Blache, M.D.

NPI #1538139712 in Valdosta, Georgia

Provider Information

NPI Number: 1538139712
Entity Type: Individual
Name: MRS. Charlene Carla Blache, M.D.
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Pediatrics
Credential: M.D.
Enumeration Date: Jan 23, 2006
Last Updated: Sep 8, 2015

Practice Location

Address: 406 M NORTHSIDE DRIVE
City: Valdosta
State: Georgia
ZIP Code: 31602-1853
Phone: (229) 241-0059

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pediatrics	208000000X	Primary

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