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Individual

DR. EDWARD JOSEPH RICCIARDELLI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1717 SHIPYARD BLVD, SUITE 100, WILMINGTON, NC 28403
(910) 794-5355
(910) 794-5358
Mailing address
1717 SHIPYARD BLVD, SUITE 100, WILMINGTON, NC 28403
(910) 794-5355
(910) 794-5355

Taxonomy

Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
9600699
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
011E3
BLUE CROSS GROUP ID
NC
01
1328886
UNITED HEALTH CARE
NC
01
71471
BLUE CROSS INDIVIDUAL
NC
05
8971471
NC
Enumeration date
06/16/2005
Last updated
12/16/2010
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