Basic Information
| Provider Information | |||||||||
| NPI: | 1396275103 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KAYSERIAN | ||||||||
| FirstName: | EDWARD | ||||||||
| MiddleName: | YEPREM | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 60447 | ||||||||
| Address2: | |||||||||
| City: | CHARLOTTE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 282600447 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3364743444 | ||||||||
| FaxNumber: | 3362779183 | ||||||||
| Practice Location | |||||||||
| Address1: | 207 OLD LEXINGTON RD | ||||||||
| Address2: | |||||||||
| City: | THOMASVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 273603428 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3364743444 | ||||||||
| FaxNumber: | 3362779183 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/14/2017 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/06/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208M00000X | 2020-03022 | NC | Y | Allopathic & Osteopathic Physicians | Hospitalist |
No ID Information.