Provider Demographics
NPI:1184724338
Name:EDMUNDS, JOHN H (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:H
Last Name:EDMUNDS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:321 MULBERRY ST SW
Mailing Address - Street 2:MEDICAL STAFF SERVICES
Mailing Address - City:LENOIR
Mailing Address - State:NC
Mailing Address - Zip Code:28645-5720
Mailing Address - Country:US
Mailing Address - Phone:828-757-5965
Mailing Address - Fax:828-757-5104
Practice Address - Street 1:322 MULBERRY STREET, SW
Practice Address - Street 2:SUITE F
Practice Address - City:LENOIR
Practice Address - State:NC
Practice Address - Zip Code:28645-5703
Practice Address - Country:US
Practice Address - Phone:828-757-6462
Practice Address - Fax:828-757-6490
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2016-12-29
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Provider Licenses
StateLicense IDTaxonomies
NC9500065207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8930121Medicaid
NCNC4826B408Medicare PIN
NC8930121Medicaid
NC30121OtherBCBS OF NC
NC82466OtherMEDCOST
NC110115298Medicare PIN
NC2501884OtherUHC OF NC
NC9446OtherPARTNERS MEDICARE