Individual
DR. EDWARD NOONAN SQUIRE JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1528 7 LKS N, WEST END, NC 27376-8362
(910) 673-3673
Mailing address
1528 7 LKS N, WEST END, NC 27376-8362
(910) 673-3673
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
9801509
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
891189Q
—
NC
Enumeration date
09/22/2006
Last updated
07/08/2007
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