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General NPI Number Information
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NPI Number | 1548280860
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Entity Type | Individual
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Provider Name | WALTER C EDWARDS MD
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Gender | Male
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Dates
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Enumeration Date | 07/20/2006
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Last Update Date | 08/14/2015
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Provider Practice Location Address
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Address Line | 993 C JOHNSON FERRY RD STE 100
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City | ATLANTA
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State | GA
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Zip | 30342
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Country | US
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Telephone | 404-255-1180
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Fax | 404-250-0071
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Provider Business Mailing Address
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Address Line | 980 JOHNSON FERRY RD 740
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City | ATLANTA
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State | GA
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Zip | 30342-1629
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Country | US
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Telephone | 404-355-5479
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Fax | 404-250-0071
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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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 013030
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License Number State | GA
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