Provider Demographics
NPI:1821185489
Name:WALDROP, EDWIN HAROLD JR (NP)
Entity type:Individual
Prefix:MR
First Name:EDWIN
Middle Name:HAROLD
Last Name:WALDROP
Suffix:JR
Gender:M
Credentials:NP
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Mailing Address - Street 1:PO BOX 878
Mailing Address - Street 2:
Mailing Address - City:RUTHERFORDTON
Mailing Address - State:NC
Mailing Address - Zip Code:28139-0878
Mailing Address - Country:US
Mailing Address - Phone:828-287-7806
Mailing Address - Fax:828-287-0004
Practice Address - Street 1:182 W COURT ST
Practice Address - Street 2:
Practice Address - City:RUTHERFORDTON
Practice Address - State:NC
Practice Address - Zip Code:28139-2805
Practice Address - Country:US
Practice Address - Phone:828-287-7806
Practice Address - Fax:828-287-0004
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-06
Last Update Date:2015-02-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC0050-02616363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6113028Medicaid
NC6113028Medicaid