Individual
DIANE R EDWARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
915 S DAVID, CASPER, WY 82601
(307) 472-3769
Mailing address
915 S DAVID, CASPER, WY 82601
(307) 472-3769
Taxonomy
Speciality
Code
Description
License number
State
2080P0006X
Developmental - Behavioral Pediatrics Physician
Primary
5214A
WY
Other
Enumeration date
11/28/2006
Last updated
07/08/2007
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