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Individual

DR. DOUGLAS W EDGREN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1331 PRAIRIE AVE STE 1, CHEYENNE, WY 82009-4867
(307) 632-0728
Mailing address
1331 PRAIRIE AVE STE 1, CHEYENNE, WY 82009-4867
(307) 632-0728

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
036091285
IL
207Q00000X
Family Medicine Physician
Primary
5108A
WY

Other

Enumeration date
06/23/2006
Last updated
06/08/2021
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