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NPI Code Detail

MEDICARE: DR. JAMES BRYANT EDWARDS III M.D.

MEDICARE: DR. JAMES BRYANT EDWARDS III M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialist5875SC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
21346244951OTHERSCNPI
3201203904OTHERSCTAX ID

General Provider Information

NPI Number : 1346244951
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JAMES BRYANT EDWARDS III M.D.
Provider Business Mailing Address
First Line : 1306 N FRASER ST
Second Line :
City : GEORGETOWN
State : SC
Zip : 29440-2800
Country : US
Telephone Number : 843-546-3132
Fax Number : 843-546-2268
Provider Business Practice Location Address
First Line : 1306 N FRASER ST
Second Line :
City : GEORGETOWN
State : SC
Zip : 29440-2800
Country : US
Telephone Number : 843-546-3132
Fax Number : 843-546-2268
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/10/2005
Last Update Date : 01/29/2010

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