Provider Demographics
NPI:1760452676
Name:CLOUD, EDITH ELAINE (MD)
Entity Type:Individual
Prefix:MS
First Name:EDITH
Middle Name:ELAINE
Last Name:CLOUD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:12925 HIGHWAY 601
Mailing Address - Street 2:MIDLAND FAMILY MEDICINE
Mailing Address - City:MIDLAND
Mailing Address - State:NC
Mailing Address - Zip Code:28107-9536
Mailing Address - Country:US
Mailing Address - Phone:704-888-3702
Mailing Address - Fax:704-888-4192
Practice Address - Street 1:12925 HIGHWAY 601
Practice Address - Street 2:MIDLAND FAMILY MEDICINE
Practice Address - City:MIDLAND
Practice Address - State:NC
Practice Address - Zip Code:28107-9536
Practice Address - Country:US
Practice Address - Phone:704-888-3702
Practice Address - Fax:704-888-4192
Is Sole Proprietor?:No
Enumeration Date:2006-01-24
Last Update Date:2013-06-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC9900190207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3551768OtherAETNA
NC49135OtherPARTNERS MEDICARE CHOICE
NC8041332OtherCIGNA HEALTHCARE
NCP00167170OtherRAILROAD MEDICARE
NC89130NFMedicaid
NC2124562OtherMAMSI
NC130NFOtherBCBS
NC0104984OtherUNITED HEALTHCARE
NCD4021OtherMEDCOST
NC566000156OtherGROUP TAX ID
NC89130NFMedicaid
NC0104984OtherUNITED HEALTHCARE
NC8041332OtherCIGNA HEALTHCARE