Provider Demographics
NPI:1699760959
Name:EARWOOD, ALFRED DOUGLAS (MD)
Entity type:Individual
Prefix:DR
First Name:ALFRED
Middle Name:DOUGLAS
Last Name:EARWOOD
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 1568
Mailing Address - Street 2:
Mailing Address - City:BANNER ELK
Mailing Address - State:NC
Mailing Address - Zip Code:28604-1568
Mailing Address - Country:US
Mailing Address - Phone:828-898-5177
Mailing Address - Fax:828-898-8306
Practice Address - Street 1:150 PARK AVE
Practice Address - Street 2:
Practice Address - City:BANNER ELK
Practice Address - State:NC
Practice Address - Zip Code:28604-6604
Practice Address - Country:US
Practice Address - Phone:828-898-5177
Practice Address - Fax:828-898-8306
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-13
Last Update Date:2011-06-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC33815207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC29876OtherNC BLUECROSSBLUESHIELD
NC110094760OtherNC RAILROAD MEDICARE
TN4406013Medicaid
NC8929876Medicaid
TN178522OtherTN BLUECROSS & TENNCARE
NC8929876Medicaid
NC110094760OtherNC RAILROAD MEDICARE
NC29876OtherNC BLUECROSSBLUESHIELD