Individual
MR. EDWARD CALVIN SIMPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CSA
Contact information
Practice address
4850 BRIERWOOD RD, LA PLATA, MD 20646-5602
(301) 392-1177
(301) 392-1177
Mailing address
PO BOX 277, POMFRET, MD 20675-0277
(301) 752-1578
(301) 392-1177
Taxonomy
Speciality
Code
Description
License number
State
246ZS0410X
Surgical Technologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
521800757
FED TAX I.D. #
—
Enumeration date
11/05/2005
Last updated
11/21/2011
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