Individual
CHARLES C EDWARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
301 SAINT PAUL ST, SPINE CENTER, LOWER LEVEL, BALTIMORE, MD 21202-2102
(410) 539-3434
(410) 366-2202
Mailing address
PO BOX 630594, BALTIMORE, MD 21263-0594
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
D0018793
MD
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
D0018793
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
305191900
—
MA
01
—
F 482 / 0002
BLUE CHOICE
MD
01
—
LZ51/310240-03
BC/BS OF MD
MD
01
—
LZ51/310240-07,08,09
BC/BS OF MD
MD
Enumeration date
08/30/2006
Last updated
03/07/2008
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