MEDICARE: DR. WALTER GARLAND EDWARDS JR. 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
1	207RN0300X	Nephrology Physician	4799	SC

General Provider Information

NPI Number	:	1982924304
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WALTER GARLAND EDWARDS JR. M.D.

Provider Business Mailing Address
First Line	:	6447 EASTSHORE RD
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29206-3305
Country	:	US
Telephone Number	:	803-787-8310
Fax Number	:

Provider Business Practice Location Address
First Line	:	6447 EASTSHORE RD
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29206-3305
Country	:	US
Telephone Number	:	803-787-8310
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/08/2010
Last Update Date	:	06/08/2010

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