Healthcare Provider Details

I. General information

NPI: 1316988058
Provider Name (Legal Business Name): EDWARD THURMAN PLYLER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2006
Last Update Date: 02/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2201 S STERLING ST
MORGANTON NC
28655-4044
US

IV. Provider business mailing address

2201 S STERLING ST
MORGANTON NC
28655-4044
US

V. Phone/Fax

Practice location:
  • Phone: 828-580-6892
  • Fax: 828-580-5138
Mailing address:
  • Phone: 828-580-6892
  • Fax: 828-580-5138

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number28077
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: