National Provider Identifier Database

MARK T EDGE, PHD MD – NPI #1003899766
Diagnostic Radiology

A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.

Contact Information

MARK T EDGE, PHD MD
620 SUMMIT CROSSING PL
STE 106
GASTONIA, NC  28054
Phone: 704-867-8021
Fax: 704-864-4606
Website:
Specialty Taxonomy Code
* Diagnostic Radiology 2085R0202X
Neuroradiology 2085N0700X

* Indicates primary specialty

NPI Profile & details for MARK T EDGE

NPI Number 1003899766
Credentials PHD MD
Entity Individual
Enumeration date 11/26/2005
Last updated 08/23/2010 - About 16 years ago
Sole proprietor1 No
Identifiers
  • NC License #: 200200890
  • NC Medicaid: 89132UH
  • SC Medicaid: N0089D
  • Other: 3616445 AETNA HMO
  • Other: 7436626 AETNA PPO
  • Other: 132UH BLUE CROSS BLUE SHIELD
  • Other: D4988 MEDCOST
  • Other: 801319 PARTNERS
  • Other: P00167818 RAILROAD MEDICARE
  • Other: 560988142 UNITED HEALTHCARE
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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