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General NPI Number Information
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NPI Number | 1790736809
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Entity Type | Individual
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Provider Name | EDWARD WARREN III M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/13/2006
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Last Update Date | 12/07/2025
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Provider Practice Location Address
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Address Line | 595 W CAROLINA AVE
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City | VARNVILLE
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State | SC
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Zip | 29944-4735
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Country | US
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Telephone | 803-943-7600
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Fax | 803-943-7601
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Provider Business Mailing Address
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Address Line | 595 W CAROLINA AVE
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City | VARNVILLE
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State | SC
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Zip | 29944-4735
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Country | US
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Telephone | 803-943-7600
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Fax | 803-943-7601
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 07713
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License Number State | SC
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