Healthcare Provider Details

I. General information

NPI: 1841261971
Provider Name (Legal Business Name): MICHAEL S EDWARDS PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/27/2006
Last Update Date: 07/12/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8901 WISCONSIN AVE
BETHESDA MD
20889-0001
US

IV. Provider business mailing address

8901 WISCONSIN AVE
BETHESDA MD
20889-0001
US

V. Phone/Fax

Practice location:
  • Phone: 301-319-2160
  • Fax:
Mailing address:
  • Phone: 301-319-2160
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number09343
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: