Individual
MR. EDWARD SHALOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CPT, FNS
Contact information
Practice address
4111 JEFFERSON ST, HYATTSVILLE, MD 20781-1705
(240) 383-0139
Mailing address
2316 RHODE ISLAND AVE NE, WASHINGTON, DC 20018-2829
(240) 383-0139
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
T212693
MD
Other
Enumeration date
06/06/2021
Last updated
06/06/2021
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