Provider Demographics
NPI:1093752933
Name:WILLIAM W. HEDRICK, M.D. PA
Entity Type:Organization
Organization Name:WILLIAM W. HEDRICK, M.D. PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:W
Authorized Official - Last Name:HEDRICK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:919-231-6215
Mailing Address - Street 1:1805 N NEW HOPE RD
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27604-4715
Mailing Address - Country:US
Mailing Address - Phone:919-231-6215
Mailing Address - Fax:919-231-7784
Practice Address - Street 1:1805 N NEW HOPE RD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27604-4715
Practice Address - Country:US
Practice Address - Phone:919-231-6215
Practice Address - Fax:919-231-7784
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-31
Last Update Date:2007-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCDF6217OtherMEDICARE RAILROAD
NCDF6217OtherMEDICARE RAILROAD