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General NPI Number Information
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NPI Number | 1316933492
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Entity Type | Individual
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Provider Name | EDWARD W. KIGGUNDU MD
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Gender | Male
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Dates
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Enumeration Date | 09/23/2005
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Last Update Date | 09/15/2007
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Provider Practice Location Address
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Address Line | 2000 FOUNDATION WAY SUITE 1100
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City | MARTINSBURG
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State | WV
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Zip | 25401-9003
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Country | US
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Telephone | 304-262-8800
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Fax | 304-262-8203
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Provider Business Mailing Address
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Address Line | 2234 COLONIAL BLVD
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City | FORT MYERS
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State | FL
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Zip | 33907-1412
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Country | US
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Telephone | 239-931-7342
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Fax | 239-931-7385
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | D0059245
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License Number State | WV
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