Healthcare Provider Details

I. General information

NPI: 1356978993
Provider Name (Legal Business Name): TRENT CHRISTOPHER EDWARDS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2020
Last Update Date: 08/15/2024
Certification Date: 08/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7794 5 MILE RD
CINCINNATI OH
45230-2368
US

IV. Provider business mailing address

7794 5 MILE RD
CINCINNATI OH
45230-2368
US

V. Phone/Fax

Practice location:
  • Phone: 513-246-2300
  • Fax: 513-245-5424
Mailing address:
  • Phone: 513-246-2300
  • Fax: 513-245-5424

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number35.151561
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: