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General NPI Number Information
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NPI Number | 1255955902
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Entity Type | Individual
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Provider Name | WILLIAM EDELSON MD
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Gender | Male
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Dates
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Enumeration Date | 05/28/2020
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Last Update Date | 07/03/2025
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Provider Practice Location Address
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Address Line | 5530 MUNFORD RD STE 119
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City | RALEIGH
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State | NC
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Zip | 27612-2638
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Country | US
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Telephone | 919-782-9554
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Fax | 919-782-9130
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Provider Business Mailing Address
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Address Line | 3624 SUNNINGDALE WAY
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City | DURHAM
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State | NC
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Zip | 27707-5654
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | LL84160
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | LL84160
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License Number State | SC
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