Individual
DR. SCOTT BRIAN EDWARDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
50680 PHEASANT COVE DR, GRANGER, IN 46530-7583
(574) 273-9947
Mailing address
50680 PHEASANT COVE DR, GRANGER, IN 46530-7583
(574) 273-9947
Taxonomy
Speciality
Code
Description
License number
State
2083X0100X
Occupational Medicine Physician
Primary
01034800A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201011070
—
IN
Enumeration date
12/07/2010
Last updated
04/25/2014
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