Individual
EDWARD A MICHELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4815 ALAMEDA AVE, EL PASO, TX 79905-2705
(915) 215-4600
(915) 545-7338
Mailing address
440 RAYNOLDS ST # 51015, EL PASO, TX 79905-1613
(915) 215-4480
(915) 215-5386
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
35-081159
OH
207P00000X
Emergency Medicine Physician
Primary
R2172
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000221111
UNISON
OH
01
—
000000503561
ANTHEM
OH
05
—
200052490A
—
IN
05
—
2395886
—
OH
01
—
363840
WELLCARE MEDICAID
OH
01
—
4480675
AETNA
OH
01
—
744019
BUCKEYE MEDICAID
OH
01
—
P00011027
RAILROAD MEDICARE
OH
01
—
P00366728
MEDICARE RAILROAD
OH
Enumeration date
07/19/2006
Last updated
09/16/2019
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