Healthcare Provider Details

I. General information

NPI: 1134151855
Provider Name (Legal Business Name): EDWARD J DOWNS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2006
Last Update Date: 12/07/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1290 DIAMOND SPRINGS RD
VIRGINIA BEACH VA
23455-3701
US

IV. Provider business mailing address

1290 DIAMOND SPRINGS RD
VIRGINIA BEACH VA
23455-3701
US

V. Phone/Fax

Practice location:
  • Phone: 757-460-0700
  • Fax: 757-460-4168
Mailing address:
  • Phone: 757-460-0700
  • Fax: 757-460-4168

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number0101027345
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: