Individual
EDWARD C DESMET JR.
Active
Individual
EDWARD C DESMET JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-011714L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0066515000
INDEPENDENCE BLUE SHIELD
PA
01
—
171758
BLUE SHIELD
PA
01
—
2495044
AETNA
PA
01
—
50017318
CAPITAL BLUE CROSS
PA
01
—
812635
FIRST PRIORITY
PA
Enumeration date
11/17/2005
Last updated
03/11/2010
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