Provider Demographics
NPI:1376679571
Name:EDWARDS, BRIAN E (MD)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:E
Last Name:EDWARDS
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 1:4 VANDERBILT PARK DR
Mailing Address - Street 2:STE 100
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-2476
Mailing Address - Country:US
Mailing Address - Phone:828-258-0397
Mailing Address - Fax:828-258-3390
Practice Address - Street 1:4 VANDERBILT PARK DR
Practice Address - Street 2:STE 100
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-2476
Practice Address - Country:US
Practice Address - Phone:828-258-0397
Practice Address - Fax:828-258-3390
Is Sole Proprietor?:No
Enumeration Date:2007-02-24
Last Update Date:2022-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD69015207R00000X
NC2009-01029208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD417615400Medicaid
MD951689-01 & 02OtherBLUE CROSS/BLUE SHIELD
MDS062-0358OtherBLUE CROSS/BLUE SHIELD - REGIONAL
MDP00976309Medicare PIN
MD153494Y1PMedicare PIN