Individual
KENNETH PATRICK EDEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
885 SUMMIT CROSSING PL, GASTONIA, NC 28054-2193
(704) 316-4979
(704) 316-4978
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 316-4979
(704) 316-4978
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
9800855
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8912123
—
NC
Enumeration date
04/04/2006
Last updated
01/03/2024
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