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MATTHEW STEVENS EDWARDS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-4151
(336) 716-0524
Mailing address
100 KIMEL FOREST DR, WINSTON SALEM, NC 27103-6074
(336) 716-0238

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
9601600
NC
2086S0102X
Surgical Critical Care Physician
9601600
NC
2086S0129X
Vascular Surgery Physician
Primary
9601600
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1333T
BCBS
05
2004895000
WV
01
37162
PARTNERS
05
7302754
VA
01
7906221
AETNA
05
891333T
NC
01
C5490
MEDCOST
05
Q01601
SC
Enumeration date
12/13/2005
Last updated
03/29/2022
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