MEDICARE: EDWARD ANTONIO ESPINOSA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	059636	GA

General Provider Information

NPI Number	:	1851597397
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EDWARD ANTONIO ESPINOSA MD

Provider Business Mailing Address
First Line	:	91 W WIEUCA RD NE STE 1000
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30342-3289
Country	:	US
Telephone Number	:	404-257-5585
Fax Number	:	404-257-9985

Provider Business Practice Location Address
First Line	:	91 W WIEUCA RD NE STE 1000
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30342-3289
Country	:	US
Telephone Number	:	404-257-5585
Fax Number	:	404-257-9985

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/22/2007
Last Update Date	:	03/06/2018

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Directions to “ EDWARD ANTONIO ESPINOSA MD” Practice Location

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