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Individual

DR. SELWAN O. EDWARD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
18101 OAKWOOD BLVD, INTERIM STAY UNIT OBSERVATION CARE, DEARBORN, MI 48124
(313) 982-5770
(313) 982-5771
Mailing address
23300 ECORSE ROAD, TAYLOR, MI 48180-1768
(313) 291-9500

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
4301091975
MI
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
01081506A
IN
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
4301091975
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
12290308
CAQH
05
1376795559
MI
Enumeration date
10/19/2008
Last updated
01/10/2019
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