Individual
DR. EDWARD FRASER SPILKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1690 STONE VILLAGE LANE NW, SUITE 921, KENNESAW, GA 30152-7714
(770) 590-1440
(770) 792-9231
Mailing address
1690 STONE VILLAGE LANE NW, SUITE 921, KENNESAW, GA 30152-7714
(770) 590-1440
(770) 792-9231
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
031133
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
202I081393
MEDICARE PTAN
GA
Enumeration date
07/03/2006
Last updated
04/05/2012
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