Provider Demographics
NPI:1184176133
Name:SWAILES, EDWARD (PA)
Entity type:Individual
Prefix:
First Name:EDWARD
Middle Name:
Last Name:SWAILES
Suffix:
Gender:M
Credentials:PA
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Mailing Address - Street 1:511 PALADIN DR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-7826
Mailing Address - Country:US
Mailing Address - Phone:252-752-8880
Mailing Address - Fax:
Practice Address - Street 1:EASTERN NEPHROLOGY ASSOCIATES PLLC
Practice Address - Street 2:227 MEMORIAL DR
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28546-6333
Practice Address - Country:US
Practice Address - Phone:910-346-2263
Practice Address - Fax:910-353-0549
Is Sole Proprietor?:No
Enumeration Date:2016-10-25
Last Update Date:2021-08-19
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Provider Licenses
StateLicense IDTaxonomies
NY020318363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant