Individual
DOUGLAS EDEMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1021 W OAKLAND AVE, SUITE 207, JOHNSON CITY, TN 37604-2191
(423) 915-5116
(423) 915-5101
Mailing address
1021 W OAKLAND AVE, SUITE 207, JOHNSON CITY, TN 37604-2191
(423) 915-5116
(423) 915-5101
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD0000047134
TN
Other
Enumeration date
05/02/2012
Last updated
05/02/2012
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