Provider Demographics
NPI:1679642813
Name:RAYMOND, EDWARD CHARLES (DC)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:CHARLES
Last Name:RAYMOND
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 THOMPSON ST STE 205
Mailing Address - Street 2:
Mailing Address - City:PITTSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27312-5511
Mailing Address - Country:US
Mailing Address - Phone:919-542-6107
Mailing Address - Fax:919-490-5455
Practice Address - Street 1:358 EAST ST
Practice Address - Street 2:
Practice Address - City:PITTSBORO
Practice Address - State:NC
Practice Address - Zip Code:27312-9722
Practice Address - Country:US
Practice Address - Phone:919-542-6107
Practice Address - Fax:919-542-6107
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1725111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8908659Medicaid
NC2446721Medicare ID - Type Unspecified
NCT53175Medicare UPIN