Organization
EDWARD A. CLINE, DPM, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDWARD A CLINE DPM (PODIATRIST OWNER)
(573) 221-3266
Entity
Organization
Contact information
Practice address
109 VIRGINIA ST, SUITE 278, HANNIBAL, MO 63401-3778
(573) 221-3266
(573) 221-8066
Mailing address
109 VIRGINIA ST, SUITE 278, HANNIBAL, MO 63401-3778
(573) 221-3266
(573) 221-8066
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
0000745
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
117516
BLUE CROSS AND BLUE SHIEL
MO
05
—
30963700016
—
MO
Enumeration date
04/03/2007
Last updated
08/22/2020
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