Individual
MR. EDWARD A LANEAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
921 N WINSTEAD AVE, ROCKY MOUNT, NC 27804-8749
(252) 937-0300
(252) 937-3108
Mailing address
PO BOX 7200, ROCKY MOUNT, NC 27804-0200
(252) 937-0200
(252) 451-0056
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
101385
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
101385
LICENSE NUMBER
NC
01
—
970002946
RAILROAD MEDICARE
NC
Enumeration date
05/08/2006
Last updated
03/30/2015
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