Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | 20980 | NC |
NPI | 1003899105 |
---|---|
Provider Name | Dr. Edward L Treadwell |
First Address | Charlotte, NC 28275-1069 |
Second Address | Greenville, NC 27834-4300 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/11/2005 |
Last Update Date | 07/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
660001936 | RAILROAD MEDICARE (01) | NC |
83704 | BCBS NC (01) | NC |
8983704 | (05) | NC |
C86820 | (02) | NC |