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General NPI Number Information
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NPI Number | 1376735100
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Entity Type | Organization
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Legal Business Name | EDGER V POTTER JR MD INC
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Dates
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Enumeration Date | 08/15/2007
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Last Update Date | 09/16/2011
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Provider Practice Location Address
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Address Line | 12017 FORT WASHINGTON RD
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City | FORT WASHINGTON
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State | MD
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Zip | 20744-6004
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Country | US
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Telephone | 301-203-9570
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Fax | 301-203-1796
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Provider Business Mailing Address
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Address Line | 12017 FORT WASHINGTON RD
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City | FORT WASHINGTON
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State | MD
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Zip | 20744-6004
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Country | US
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Telephone | 301-203-9570
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Fax | 301-203-1796
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. EDGER VERDAN POTTER JR.
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Credential | MD
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Telephone | 301-203-9570
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number | MD9565
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License Number State | DC
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Taxonomy #2
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | MD9565
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License Number State | DC
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD9565
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License Number State | DC
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