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NPI Code Detail

MEDICARE: GEORGE M EDWARDS MD

MEDICARE: GEORGE M EDWARDS MD
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
1207R00000XInternal Medicine PhysicianMD09511OR

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1110154335OTHERRR MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1356392559
Entity Type Code : Individual
Provider Name (Legal Business Name) : GEORGE M EDWARDS MD
Provider Business Mailing Address
First Line : 1001 MOLALLA AVE STE 100
Second Line :
City : OREGON CITY
State : OR
Zip : 97045-3753
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1001 MOLALLA AVE STE 100
Second Line :
City : OREGON CITY
State : OR
Zip : 97045-3753
Country : US
Telephone Number : 503-656-5273
Fax Number : 503-650-4828
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/12/2006
Last Update Date : 05/03/2013

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Directions to “ GEORGE M EDWARDS MD” Practice Location

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