Provider Demographics
NPI:1962537712
Name:HOEPER, EDWIN WILLIAM (MD)
Entity type:Individual
Prefix:DR
First Name:EDWIN
Middle Name:WILLIAM
Last Name:HOEPER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1506 WAYNE MEMORIAL DR
Mailing Address - Street 2:SUITE H
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27534-2202
Mailing Address - Country:US
Mailing Address - Phone:919-736-4722
Mailing Address - Fax:919-734-3442
Practice Address - Street 1:1506 WAYNE MEMORIAL DR
Practice Address - Street 2:SUITE H
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27534-2202
Practice Address - Country:US
Practice Address - Phone:919-736-4722
Practice Address - Fax:919-734-3442
Is Sole Proprietor?:No
Enumeration Date:2007-02-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC325132084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8942825Medicaid
NC8942825Medicaid
NC212961AMedicare ID - Type Unspecified