Individual
MR. EDWARD MICHAEL BULLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPA C
Contact information
Practice address
2212 PENFIELD RD, SUITE 200, PENFIELD, NY 14526-1756
(585) 598-8555
(585) 388-1483
Mailing address
2212 PENFIELD RD, SUITE 200, PENFIELD, NY 14526-1756
(585) 598-8555
(585) 388-1483
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
23008844
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02347611
—
NY
Enumeration date
07/17/2006
Last updated
01/07/2008
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