Provider Demographics
NPI:1013371426
Name:HEDGES, BRIAN ZACHARY (MD)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:ZACHARY
Last Name:HEDGES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 BLYTHE BLVD.
Mailing Address - Street 2:CMC/DEPARTMENT OF EMERGENCY MEDICINE
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28203-5812
Mailing Address - Country:US
Mailing Address - Phone:704-355-3181
Mailing Address - Fax:704-355-7047
Practice Address - Street 1:1000 BLYTHE BLVD.
Practice Address - Street 2:CMC/DEPARTMENT OF EMERGENCY MEDICINE
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28203-5812
Practice Address - Country:US
Practice Address - Phone:704-355-3181
Practice Address - Fax:704-355-7047
Is Sole Proprietor?:No
Enumeration Date:2016-04-12
Last Update Date:2016-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC218190207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC218190OtherNORTH CAROLINA MEDICAL BOARD RTL FILE ID #