Physician Compare National (NPI:1538466206)

HEALTHCARE PROVIDER: CHARLES LOUIS EDWARDS D.O.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1538466206
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	5799921458
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20130624000137
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	EDWARDS
	Individual professional last name
Provider First Name	CHARLES
	Individual professional first name
Provider Middle Name	LOUIS
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	WEST VIRGINIA SCHOOL OF OSTEOPATHIC MEDICINE
	Individual professional's medical school
Graduation Year	2010
	Individual professional's medical school graduation year
Primary Specialty	INTERNAL MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	2716 WHIRLAWAY AVE
	Group Practice or individual's line 1 address
City	FLORENCE
	Group Practice or individual's city
State	SC
	Group Practice or individual's state
Zip Code	295058748
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	420010
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	CAROLINA PINES REGIONAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	420091
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	CAROLINAS HOSPITAL SYSTEM
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	420066
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	LAKE CITY COMMUNITY HOSPITAL
	Legal business name of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment	M