Individual
DR. EDWARD K KANKAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
293 NW PEACOCK BLVD STE 101-104, PORT SAINT LUCIE, FL 34986-2222
(772) 335-9600
(772) 879-4478
Mailing address
293 NW PEACOCK BLVD STE 101-104, PORT SAINT LUCIE, FL 34986-2222
(772) 335-9600
(772) 879-4478
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OS7965
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
260022600
—
FL
Enumeration date
12/05/2006
Last updated
10/03/2019
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