| Doctor Name: | MARK THOMAS EDGE |
| NPI Number: | 1003899766 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PHD MD |
| License Number: | 200200890 |
| Business Practice Address: | 620 Summit Crossing Pl Ste 106 Gastonia, NC - 28054 |
| Business Phone Number: | 7048678021 |
| Business Fax Number: | 7048644606 |
| Mailing Address: | 620 Summit Crossing Pl, Ste 106 GASTONIA |
| State: | NC |
| Postal Code: | 28054 |
| Phone Number: | 7048678021 |
| Fax Number: | 7048644606 |
| NPI Enumeration Date: | 11/26/2005 |
| NPI Last Update Date: | 08/23/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2085N0700X |
| License Number: | 200200890 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NC |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Radiology |
| Taxonomy Specialization: | Neuroradiology |
| Taxonomy Definition: | A radiologist who diagnoses and treats diseases utilizing imaging procedures as they relate to the brain, spine and spinal cord, head, neck and organs of special sense in adults and children. |