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Individual
EDWARD RE III
Active
Individual
EDWARD RE III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
MT210381
PA
2080S0010X
Pediatric Sports Medicine Physician
Primary
MD468533
PA
2080S0010X
Pediatric Sports Medicine Physician
MT210381
PA
Other
Enumeration date
04/29/2016
Last updated
06/29/2021
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