MR. CLYDE RICHARD EDWARDS PA-C
NPI 1194716241
Physician Assistant in Wake Forest, NC

Active since October 28, 2005
1655 WAKE DR, SUITE 101, WAKE FOREST, NC 27587(919) 556-4779(919) 556-5277 Get Directions Write a Review

NPPES record last updated: September 25, 2013. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Mr. Clyde Richard Edwards Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. CLYDE RICHARD EDWARDS PA-C (NPI 1194716241) is an individual physician assistant in Wake Forest, North Carolina, licensed in North Carolina (102843) and active in the NPI registry since October 2005.

NPPES Registry Identity

NPI1194716241
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameMR. CLYDE RICHARD EDWARDSCredential: PA-C
Location Address1655 WAKE DR, SUITE 101Wake Forest, NC 27587-4745
Mailing Address1655 Wake Dr, Suite 101Wake Forest, NC 27587-4745 · (919) 556-4779 · Fax (919) 556-5277
Fax(919) 556-5277
Sole ProprietorNo
Enumeration DateOctober 28, 2005
Last NPPES UpdateSeptember 25, 2013
NPI 1194716241 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License Licensed in NC · 102843
Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

1655 WAKE DR, Wake Forest, NC 27587

Other Identifiers 1

Other102843NC · North Carolina License

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Pediatrics
1655 WAKE DR, SUITE 101
WAKE FOREST, NC 27587
Nurse Practitioner (Pediatrics)
1655 WAKE DR, SUITE 101
WAKE FOREST, NC 27587
Pediatrics
1655 WAKE DR, SUITE 101
WAKE FOREST, NC 27587
Pediatrics (Adolescent Medicine)
1655 WAKE DR, SUITE 1001
WAKE FOREST, NC 27587
Nurse Practitioner (Pediatrics)
1655 WAKE DR, SUITE 101
WAKE FOREST, NC 27587
Clinic/Center (Dental)
1655 WAKE DR
WAKE FOREST, NC 27587
Nurse Practitioner (Family)
1655 WAKE DR
WAKE FOREST, NC 27587

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1194716241, enumerated as an "individual" on October 28, 2005.

The provider is located at 1655 WAKE DR SUITE 101 WAKE FOREST, NC 27587 and the phone number is (919) 556-4779.

Physician Assistant with taxonomy code 363A00000X.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.