Provider Demographics
NPI:1588602304
Name:EDRINGTON, RICHARD DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:DAVID
Last Name:EDRINGTON
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 1:3300 EXECUTIVE DR STE 304
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-7492
Mailing Address - Country:US
Mailing Address - Phone:919-576-8680
Mailing Address - Fax:919-576-8699
Practice Address - Street 1:3300 EXECUTIVE DR STE 304
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-7492
Practice Address - Country:US
Practice Address - Phone:919-576-8680
Practice Address - Fax:919-576-8699
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2019-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC235202086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC464895OtherANTHEM
NC4211096OtherAETNA INSURANCE
NC10630OtherPARTNERS MEDICARE
NC3750395OtherUNITEDHEALTHCARE
NCC3203OtherMEDCOST
NC30064OtherBLUE CROSS/BLUE SHIELD
NC8930064Medicaid
NCP00016341OtherMEDICARE RAILROAD
NCC3203OtherMEDCOST
NC206095BMedicare ID - Type Unspecified