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Individual

JOHN R EDWARDS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
520 SOUTH VAN BUREN ROAD, SUITE 1, EDEN, NC 27288-5019
(336) 627-7500
(336) 627-7384
Mailing address
P.O. BOX 488, EDEN, NC 27289-0488
(336) 623-9711
(336) 627-0778

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
0101-029533
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
010242151
VA
05
6408826
VA
Enumeration date
02/17/2006
Last updated
07/12/2012
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