# EDWARD LEGARE

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1710318597
- **Gender:** Man
- **Credential:** RSA

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 246ZC0007X | Surgical Assistant | 0136000017 | VA | — |
| 363AS0400X | Surgical Physician Assistant | — | VA | Yes |

## Other

- **Enumeration date:** 12/04/2013
- **Last updated:** 09/17/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0136000017 | REGISTERED SURGICAL ASSISTANT | VA |