Provider Demographics
NPI:1336303098
Name:BRIDGES, EDWARD KARL (MD)
Entity Type:Individual
Prefix:
First Name:EDWARD
Middle Name:KARL
Last Name:BRIDGES
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 1:1814 CHAPEL HILL RD
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-1106
Mailing Address - Country:US
Mailing Address - Phone:919-489-2821
Mailing Address - Fax:919-403-8115
Practice Address - Street 1:1814 CHAPEL HILL RD
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-1106
Practice Address - Country:US
Practice Address - Phone:919-489-2821
Practice Address - Fax:919-403-8115
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-11
Last Update Date:2008-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC238952084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry