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NPI Code Detail

MEDICARE: DAVID BRUCE EDMONDS MD

MEDICARE: DAVID BRUCE EDMONDS 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
12080N0001XNeonatal-Perinatal Medicine Physician8461NV

Other Identifiers

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

General Provider Information

NPI Number : 1922084573
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID BRUCE EDMONDS MD
Provider Business Mailing Address
First Line : PO BOX 82070
Second Line :
City : LAS VEGAS
State : NV
Zip : 89180-2070
Country : US
Telephone Number : 702-869-5607
Fax Number : 702-869-5607
Provider Business Practice Location Address
First Line : 657 N TOWN CENTER DR
Second Line :
City : LAS VEGAS
State : NV
Zip : 89144-6367
Country : US
Telephone Number : 702-233-7786
Fax Number : 702-233-7423
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/15/2005
Last Update Date : 05/07/2009

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Directions to “ DAVID BRUCE EDMONDS MD” Practice Location

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