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NPI Code Detail

MEDICARE: DR. MORRIS DAVID EDWARDS PHD

MEDICARE: DR. MORRIS DAVID EDWARDS PHD
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
1103TC0700XClinical Psychologist6301003125MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10C96409OTHERMIBCBSM

General Provider Information

NPI Number : 1831148659
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MORRIS DAVID EDWARDS PHD
Provider Business Mailing Address
First Line : 4328 W MICHIGAN AVE
Second Line :
City : KALAMAZOO
State : MI
Zip : 49006-5823
Country : US
Telephone Number : 269-375-2222
Fax Number : 269-375-6078
Provider Business Practice Location Address
First Line : 4328 W MICHIGAN AVE
Second Line :
City : KALAMAZOO
State : MI
Zip : 49006-5823
Country : US
Telephone Number : 269-375-2222
Fax Number : 269-375-6078
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/09/2006
Last Update Date : 01/29/2013

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