Individual
EDWIN LEO BLITCH IV
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
9313 MEDICAL PLAZA DR, 301, CHARLESTON, SC 29406-9155
(843) 553-2909
(843) 553-4684
Mailing address
9313 MEDICAL PLAZA DR, 301, CHARLESTON, SC 29406-9155
(843) 553-2909
(843) 553-4684
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
134
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PD1340
—
SC
Enumeration date
02/20/2006
Last updated
07/09/2007
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