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NPI Code Detail

MEDICARE: MICHAEL EDMUNDS

MEDICARE:   MICHAEL  EDMUNDS
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
1207X00000XOrthopaedic Surgery Physician6786NV
2207X00000XOrthopaedic Surgery PhysicianG75392CA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1200026572OTHERNVMEDICARE RAILROAD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3CC7065OTHERNVBCBS

General Provider Information

NPI Number : 1538150131
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL EDMUNDS
Provider Business Mailing Address
First Line : 973 MICA DR
Second Line : SUITE 201
City : CARSON CITY
State : NV
Zip : 89705-7255
Country : US
Telephone Number : 775-783-6190
Fax Number : 775-783-6191
Provider Business Practice Location Address
First Line : 973 MICA DRIVE
Second Line : SUITE 201
City : CARSON CITY
State : NV
Zip : 89705-7255
Country : US
Telephone Number : 775-783-6190
Fax Number : 775-783-6191
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/02/2005
Last Update Date : 07/22/2021

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Directions to “ MICHAEL EDMUNDS ” Practice Location

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