Individual
DR. BEVERLY EDWARDS EDWARDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
700 SUNSET AVE, AHOSKIE, NC 27910-3547
(252) 332-3403
Mailing address
400 MCGLOHON ST S, AHOSKIE, NC 27910-3815
(252) 332-3403
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
33816
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
241520
VIRGINA BLUE CROSS BS
VA
01
—
30147
BLUE CROSS BLUE SHIELD
NC
01
—
561929096
FEDERAL TAX ID
NC
05
—
6747655
—
VA
05
—
890160M
—
NC
05
—
8930147
—
NC
Enumeration date
05/10/2006
Last updated
07/09/2007
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