Individual
MR. GEORGE KEVIN EDWARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA LPA
Contact information
Practice address
2250 SHIPYARD BLVD SUITE 3, WILMINGTON, NC 28412
(910) 791-9625
(910) 792-9799
Mailing address
1321 ARBOR RIDGE WAY, LELAND, NC 28451
(910) 409-2758
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
2391
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
136MC
BCBS
NC
05
—
2875996
—
NC
Enumeration date
11/22/2006
Last updated
07/08/2007
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