Provider Demographics
NPI:1821001652
Name:EDWARDS, ALLEN RICHARD (MD)
Entity Type:Individual
Prefix:DR
First Name:ALLEN
Middle Name:RICHARD
Last Name:EDWARDS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2850 TATE BLVD SE
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28602-1450
Mailing Address - Country:US
Mailing Address - Phone:828-326-7000
Mailing Address - Fax:828-322-7663
Practice Address - Street 1:2850 TATE BLVD SE
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28602-1450
Practice Address - Country:US
Practice Address - Phone:828-326-7000
Practice Address - Fax:828-322-7663
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC24589207Q00000X, 2083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCC81826Medicare UPIN
NC203390DMedicare PIN