Individual
EDWARD CHARLES BRATZKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4420 LAKE BOONE TRL, RALEIGH, NC 27607-7505
(919) 784-3034
Mailing address
PO BOX 18139, RALEIGH, NC 27619-8139
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
9601244
NC
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
9601244
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050047833
RAILROAD-MEDICARE
NC
01
—
132EC
BCBS, NC
NC
01
—
21765
PARTNERS
NC
01
—
5263154
CIGNA
NC
01
—
67718
MEDCOST
NC
05
—
89132EC
—
NC
Enumeration date
08/30/2006
Last updated
03/30/2021
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