Provider Demographics
NPI:1922048578
Name:HEDRICK, WILLIAM WESTON (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:WESTON
Last Name:HEDRICK
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 1:1805 N NEW HOPE RD
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27604-4715
Mailing Address - Country:US
Mailing Address - Phone:919-231-6215
Mailing Address - Fax:919-231-7784
Practice Address - Street 1:1805 N NEW HOPE RD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27604-4715
Practice Address - Country:US
Practice Address - Phone:919-231-6215
Practice Address - Fax:919-231-7784
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2007-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10830207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC41090OtherBLUECROSS BLUE SHIELD
NC8941090Medicaid
NCP00379938OtherMEDICARE RAILROAD
NC8941090Medicaid