Basic Information
Provider Information
NPI: 1376537910
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: RAMSEY
FirstName: EDWARD
MiddleName: ALLISON
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 7200
Address2:  
City: ROCKY MOUNT
State: NC
PostalCode: 278040200
CountryCode: US
TelephoneNumber: 2529370200
FaxNumber: 2524510056
Practice Location
Address1: 91 ENTERPRISE DR
Address2:  
City: ROCKY MOUNT
State: NC
PostalCode: 278049590
CountryCode: US
TelephoneNumber: 2524513100
FaxNumber: 2529373106
Other Information
ProviderEnumerationDate: 09/09/2005
LastUpdateDate: 03/08/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208000000X20186NCY Allopathic & Osteopathic PhysiciansPediatrics 

ID Information
IDTypeStateIssuerDescription
897011005NC MEDICAID
144901301NCUNITED HEALTH CAREOTHER
50000580901NCRAILROAD MEDICAREOTHER
154396901NCCIGNA HEALTHCAREOTHER
B663701NCMEDCOSTOTHER
7011001NCBCBSNCOTHER


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