Provider Demographics
NPI:1649829557
Name:EDWARDS, BRYAN TERENCE (PA-C)
Entity type:Individual
Prefix:
First Name:BRYAN
Middle Name:TERENCE
Last Name:EDWARDS
Suffix:
Gender:M
Credentials:PA-C
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2000 PERIMETER PARK DR STE 200
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560-8442
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:34 HEALTHPARK WAY STE 100
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:NC
Practice Address - Zip Code:27520-4497
Practice Address - Country:US
Practice Address - Phone:919-585-8850
Practice Address - Fax:919-585-8869
Is Sole Proprietor?:No
Enumeration Date:2019-09-04
Last Update Date:2022-02-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC001009407363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant