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General NPI Number Information
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NPI Number | 1548246952
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Entity Type | Individual
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Provider Name | JESS DAVID EDISON M.D.
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Gender | Male
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Dates
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Enumeration Date | 12/16/2005
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Last Update Date | 04/18/2024
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Provider Practice Location Address
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Address Line | WALTER REED NATIONAL MILITARY CTR 4954 NORTH PALMER ROAD
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City | BETHESDA
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State | MD
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Zip | 20889-0001
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Country | US
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Telephone | 301-295-4512
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Fax |
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Provider Business Mailing Address
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Address Line | 9400 LINDEN AVE
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City | BETHESDA
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State | MD
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Zip | 20814-1605
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Country | US
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Telephone | 301-295-4512
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Fax |
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 21392
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License Number State | NE
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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 | 21392
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License Number State | NE
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