Individual
DR. EDWARD BLEASE EADIE JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1134 N ROAD ST, SUITE 5, ELIZABETH CITY, NC 27909-3365
(252) 338-3600
(252) 338-8673
Mailing address
1134 N ROAD ST, SUITE 5, ELIZABETH CITY, NC 27909-3365
(252) 338-3600
(252) 338-8673
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
18943
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1780672071
—
NC
01
—
23290
MEDCOST
NC
01
—
29670
BLUE CROSS BLUE SHIELD
NC
05
—
8929670
—
NC
05
—
NC2727
—
SC
Enumeration date
10/11/2005
Last updated
06/30/2016
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