Organization
LINCOLN UROLOGY PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDWARD B MIEDEMA M.D. (OWNER)
(704) 732-4409
Entity
Organization
Contact information
Practice address
206 GAMBLE DR, SUITE C, LINCOLNTON, NC 28092-4439
(704) 732-4409
(704) 735-5784
Mailing address
206 GAMBLE DR, SUITE C, LINCOLNTON, NC 28092-4439
(704) 732-4409
(704) 735-5784
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
89135MK
—
NC
Enumeration date
08/23/2005
Last updated
01/07/2008
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