Healthcare Provider Details

I. General information

NPI: 1760460406
Provider Name (Legal Business Name): WILLIAM EDWARDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/04/2006
Last Update Date: 04/06/2021
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

464 ALLEGHENY BLVD 2A
FRANKLIN PA
16323-6210
US

IV. Provider business mailing address

464 ALLEGHENY BLVD 2A
FRANKLIN PA
16323-6210
US

V. Phone/Fax

Practice location:
  • Phone: 814-432-7327
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberMD026232E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: