Edwards, Clyde Richard

Edwards, Clyde Richard is an individual health care provider with primary practice located at 1655 Wake Dr Suite 101, Wake Forest NC 27587-4745. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Edwards, Clyde Richard can be contacted via phone (919) 556-4779.

Contact Information

Primary practice address
1655 Wake Dr Suite 101 Wake Forest NC 27587-4745
Phone: (919) 556-4779
Fax: (919) 556-5277
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 102843 North Carolina

Profile Details

NPI number 1194716241
LBN Legal business name Edwards, Clyde Richard
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 28th, 2005
Last updated Sep 25th, 2013 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1194716241 NPPES
North Carolina Other 102843 NORTH CAROLINA LICENSE

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