Individual
DR. EDWARD A. EVERETT JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
100 N ACADEMY AVE, DANVILLE, PA 17822-2710
(570) 271-8091
(570) 271-5879
Mailing address
100 N ACADEMY AVE, CREDENTIALS DEPT, DANVILLE, PA 17822-4903
(570) 271-6144
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
OS012189
PA
2080N0001X
Neonatal-Perinatal Medicine Physician
OS012189
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0019295770001
—
PA
Enumeration date
03/06/2006
Last updated
08/20/2020
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