Provider Demographics
NPI:1801807946
Name:KOLAR, EDWARD WARREN III (MD)
Entity type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:WARREN
Last Name:KOLAR
Suffix:III
Gender:M
Credentials:MD
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Mailing Address - Street 1:508 FULTON STREET
Mailing Address - Street 2:DVAMC
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-3875
Mailing Address - Country:US
Mailing Address - Phone:919-255-1541
Mailing Address - Fax:919-255-1540
Practice Address - Street 1:508 FULTON ST
Practice Address - Street 2:DVAMC
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-3875
Practice Address - Country:US
Practice Address - Phone:919-255-1541
Practice Address - Fax:919-255-1540
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2014-01-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC0094-00547207Q00000X
NC208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Not Answered208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8949331Medicaid
F94582Medicare UPIN
NC205986CMedicare ID - Type Unspecified