Provider Demographics
NPI:1427492230
Name:HAYWOOD, EDMUND BURKE JR (MD)
Entity type:Individual
Prefix:DR
First Name:EDMUND
Middle Name:BURKE
Last Name:HAYWOOD
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2311 DELANEY AVE
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-6012
Mailing Address - Country:US
Mailing Address - Phone:910-762-8754
Mailing Address - Fax:
Practice Address - Street 1:2311 DELANEY AVE
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-6012
Practice Address - Country:US
Practice Address - Phone:910-762-8754
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-23
Last Update Date:2021-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2018-01092207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology